RETRACTED: Gadolinium-Free Cardiac MR Stress T1-Mapping to Distinguish Epicardial From Microvascular Coronary Disease

• DOI: 10.1016/j.jacc.2017.11.071
• Publication Date: 2018-02-26T22:30:47Z
• Authors: Alexander Liu; Rohan S. Wijesure...; Joanna M. Liu; Andreas Greiser; Michael Jerosch-H...; John C. Forfar; Keith M. Channon; Stefan K. Piechnik; Stefan Neubauer; Rajesh K. Kharbanda; Vanessa M. Ferreira
• Keywords: Cardiac syndrome X; Fractional Flow Reserve; Coronary circulation

Novel cardiac magnetic resonance (CMR) stress T1 mapping can detect ischemia and myocardial blood volume changes without contrast agents may be a more comprehensive biomarker than flow.This study describes the performance of first prospective validation against invasive coronary measurements for detecting obstructive epicardial artery disease (CAD), defined by fractional flow reserve (FFR <0.8), microvascular dysfunction, FFR ≥0.8 index microcirculatory resistance (IMR ≥25 U), compared with first-pass perfusion imaging.Ninety subjects (60 patients angina; 30 healthy control subjects) underwent CMR (1.5- 3-T) to assess left ventricular function (cine), (adenosine stress/rest perfusion), infarction (late gadolinium enhancement). IMR were assessed ≤7 days post-CMR. Stress rest images analyzed blinded other information.Normal reactivity (ΔT1) was 6.2 ± 0.4% (1.5-T) 1.3% (3-T). Ischemic viable myocardium downstream CAD showed near-abolished (ΔT1 = 0.7 0.7%). Myocardium nonobstructive arteries dysfunction less-blunted 3.0 0.9%). significantly outperformed gadolinium-based perfusion, including absolute quantification flow, (area under receiver-operating characteristic curve: 0.97 0.02 vs. 0.91 0.03, respectively; p < 0.001). A ΔT1 1.5% accurately detected (sensitivity: 93%; specificity: 95%; 0.001), whereas 4.0% 0.95 0.03; sensitivity: 94%; 94%: 0.001).CMR differentiated between or radiation.