Dataset Information

Evaluation of non-invasive imaging parameters in coronary microvascular disease: a systematic review.

ABSTRACT:

Background

Coronary microvascular dysfunction (CMD) is an important underlying cause of angina pectoris. Currently, no diagnostic tool is available to directly visualize the coronary microvasculature. Invasive microvascular reactivity testing is the diagnostic standard for CMD, but several non-invasive imaging techniques are being evaluated. However, evidence on reported non-invasive parameters and cut-off values is limited. Thus, we aimed to provide an overview of reported non-invasive parameters and corresponding cut-off values for CMD.

Methods

Pubmed and EMBASE databases were systematically searched for studies enrolling patients with angina pectoris without obstructed coronary arteries, investigating at least one non-invasive imaging technique to quantify CMD. Methodological quality assessment of included studies was performed using QUADAS-2.

Results

Thirty-seven studies were included. Ten cardiac magnetic resonance studies reported MPRI and nine positron emission tomography (PET) and transthoracic echocardiography (TTE) studies reported CFR. Mean MPRI ranged from 1.47?±?0.36 to 2.01?±?0.41 in patients and from 1.50?±?0.47 to 2.68?±?0.49 in controls without CMD. Reported mean CFR in PET and TTE ranged from 1.39?±?0.31 to 2.85?±?1.35 and 1.69?±?0.40 to 2.40?±?0.40 for patients, and 2.68?±?0.83 to 4.32?±?1.78 and 2.65?±?0.65 to 3.31?±?1.10 for controls, respectively.

Conclusions

This systematic review summarized current evidence on reported parameters and cut-off values to diagnose CMD for various non-invasive imaging modalities. In current clinical practice, CMD is generally diagnosed with a CFR less than 2.0. However, due to heterogeneity in methodology and reporting of outcome measures, outcomes could not be compared and no definite reference values could be provided.

SUBMITTER: Groepenhoff F

PROVIDER: S-EPMC7789672 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Evaluation of non-invasive imaging parameters in coronary microvascular disease: a systematic review.

Groepenhoff F F Klaassen R G M RGM Valstar G B GB Bots S H SH Onland-Moret N C NC Den Ruijter H M HM Leiner T T Eikendal A L M ALM

BMC medical imaging 20210106 1

<h4>Background</h4>Coronary microvascular dysfunction (CMD) is an important underlying cause of angina pectoris. Currently, no diagnostic tool is available to directly visualize the coronary microvasculature. Invasive microvascular reactivity testing is the diagnostic standard for CMD, but several non-invasive imaging techniques are being evaluated. However, evidence on reported non-invasive parameters and cut-off values is limited. Thus, we aimed to provide an overview of reported non-invasive ...[more]

PMID: 33407208

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Project description:Evaluation of recurrent angina after percutaneous coronary interventions is challenging. Since bioresorbable vascular scaffolds (BVS) cause no artefacts in magnetic resonance imaging (MRI) due to their polylactate-based backbone, evaluation of vascular patency by MRI might allow for non-invasive assessment and triage of patients with suspected BVS failure.Patients with polylactate-based ABSORB-BVS in proximal coronary segments were examined with 3 Tesla MRI directly (baseline) and one year after implantation. For assessment of coronary patency, a high-resolution 3D spoiled gradient echo pulse sequence with fat-saturation, T2-preparation (TE: 40 ms), respiratory and end-diastolic cardiac gating, and a spatial resolution of (1.08 mm)3 was positioned parallel to the course of the vessel for bright blood imaging. In addition, a 3D navigator-gated T2-weighted variable flip angle turbo spin echo (TSE) sequence with dual-inversion recovery black-blood preparation and elliptical k-space coverage was applied with a voxel size of (1.14 mm)3. For quantitative evaluation lumen diameters of the scaffolded areas were measured in reformatted bright and black blood MR angiography data.11 patients with implantation of 16 BVS in the proximal coronary segments were included, of which none suffered from major adverse cardiac events during the one year follow up. Vascular patency in all segments implanted with BVS could be reliably assessed by MRI at baseline and after one year, whereas segments with metal stents could not be evaluated due to artefacts. Luminal diameter within the BVS remained constant during the one year period. One patient with atypical angina after BVS implantation was noninvasively evaluated showing a patent vessel, also confirmed by coronary angiography.Coronary MRI allows contrast-agent free and non-invasive assessment of vascular patency after ABSORB-BVS implantation. This approach might be supportive in the triage and improvement of diagnostic workflows in patients with postinterventional angina and scaffold implantation.German Register of Clinical Studies DRKS00007456.

Dataset Information

Evaluation of non-invasive imaging parameters in coronary microvascular disease: a systematic review.

Background

Methods

Results

Conclusions

Publications

Evaluation of non-invasive imaging parameters in coronary microvascular disease: a systematic review.

Similar Datasets

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