A meta-analysis of 14 studies has shown that MRI heart function stress has a high NPV for adverse cardiac events, and the absence of inducible perfusion defect or wall motion abnormality shows a similar ability to identify patients with a low risk for adverse cardiac events among patients with known or suspected CAD [49]. The MR- INFORM trial investigated MRI perfusion versus combined invasive angiography with invasive FFR in patients with stable angina and an intermediate to high risk of disease. The study showed that MRI perfusion had noninferior major adverse cardiac events compared with invasive FFR with the added patient benefit of a lower incidence of revascularization [50]. A meta-analysis from pooled studies found that perfusion MRI heart function stress has a sensitivity of 89.1% and a specificity of 84.9% on a patient-based analysis using FFR as a reference, suggesting that stress perfusion MRI remains an accurate test for the detection of flow-limiting stenosis in patients with suspected or established CAD [6]. In another meta-analysis of 37 studies, including 2,191 patients with high CAD prevalence, stress CMR, using either wall motion abnormality or perfusion abnormality technique, demonstrates overall good sensitivity and specificity for the diagnosis of CAD; stress-induced wall motion abnormalities imaging demonstrated a sensitivity of 0.83 and specificity of 0.86 on a patient level (disease prevalence = 70.5%). Stress perfusion imaging demonstrated a sensitivity of 0.91 and specificity of 0.81 on a patient level (disease prevalence = 57.4%) [51]. In patients with known or suspected CAD, the presence of late gadolinium enhancement and stress perfusion defect plus abnormal wall motion are independent predictors of all hard cardiac events [52]. MRI Heart Function with Stress Without IV Contrast MRI heart function stress without IV contrast can provide assessment of ventricular function/wall motion abnormalities.
Chronic Chest Pain High Probability of Coronary Artery Disease PCAs. A meta-analysis of 14 studies has shown that MRI heart function stress has a high NPV for adverse cardiac events, and the absence of inducible perfusion defect or wall motion abnormality shows a similar ability to identify patients with a low risk for adverse cardiac events among patients with known or suspected CAD [49]. The MR- INFORM trial investigated MRI perfusion versus combined invasive angiography with invasive FFR in patients with stable angina and an intermediate to high risk of disease. The study showed that MRI perfusion had noninferior major adverse cardiac events compared with invasive FFR with the added patient benefit of a lower incidence of revascularization [50]. A meta-analysis from pooled studies found that perfusion MRI heart function stress has a sensitivity of 89.1% and a specificity of 84.9% on a patient-based analysis using FFR as a reference, suggesting that stress perfusion MRI remains an accurate test for the detection of flow-limiting stenosis in patients with suspected or established CAD [6]. In another meta-analysis of 37 studies, including 2,191 patients with high CAD prevalence, stress CMR, using either wall motion abnormality or perfusion abnormality technique, demonstrates overall good sensitivity and specificity for the diagnosis of CAD; stress-induced wall motion abnormalities imaging demonstrated a sensitivity of 0.83 and specificity of 0.86 on a patient level (disease prevalence = 70.5%). Stress perfusion imaging demonstrated a sensitivity of 0.91 and specificity of 0.81 on a patient level (disease prevalence = 57.4%) [51]. In patients with known or suspected CAD, the presence of late gadolinium enhancement and stress perfusion defect plus abnormal wall motion are independent predictors of all hard cardiac events [52]. MRI Heart Function with Stress Without IV Contrast MRI heart function stress without IV contrast can provide assessment of ventricular function/wall motion abnormalities.