Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12968-021-00705-8
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dc.titleMultiparametric exercise stress cardiovascular magnetic resonance in the diagnosis of coronary artery disease: the EMPIRE trial
dc.contributor.authorLe, TT
dc.contributor.authorAng, BWY
dc.contributor.authorBryant, JA
dc.contributor.authorChin, CY
dc.contributor.authorYeo, KK
dc.contributor.authorWong, PEH
dc.contributor.authorHo, KW
dc.contributor.authorTan, JWC
dc.contributor.authorLee, PT
dc.contributor.authorChin, CWL
dc.contributor.authorCook, SA
dc.date.accessioned2022-06-07T09:16:59Z
dc.date.available2022-06-07T09:16:59Z
dc.date.issued2021-12-01
dc.identifier.citationLe, TT, Ang, BWY, Bryant, JA, Chin, CY, Yeo, KK, Wong, PEH, Ho, KW, Tan, JWC, Lee, PT, Chin, CWL, Cook, SA (2021-12-01). Multiparametric exercise stress cardiovascular magnetic resonance in the diagnosis of coronary artery disease: the EMPIRE trial. Journal of Cardiovascular Magnetic Resonance 23 (1) : 17-. ScholarBank@NUS Repository. https://doi.org/10.1186/s12968-021-00705-8
dc.identifier.issn1097-6647
dc.identifier.issn1532-429X
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/226663
dc.description.abstractBackground: Stress cardiovascular magnetic resonance (CMR) offers assessment of ventricular function, myocardial perfusion and viability in a single examination to detect coronary artery disease (CAD). We developed an in-scanner exercise stress CMR (ExCMR) protocol using supine cycle ergometer and aimed to examine the diagnostic value of a multiparametric approach in patients with suspected CAD, compared with invasive fractional flow reserve (FFR) as the reference gold standard. Methods: In this single-centre prospective study, patients who had symptoms of angina and at least one cardiovascular disease risk factor underwent both ExCMR and invasive angiography with FFR. Rest-based left ventricular function (ejection fraction, regional wall motion abnormalities), tissue characteristics and exercise stress-derived (perfusion defects, inducible regional wall motion abnormalities and peak exercise cardiac index percentile-rank) CMR parameters were evaluated in the study. Results: In the 60 recruited patients with intermediate CAD risk, 50% had haemodynamically significant CAD based on FFR. Of all the CMR parameters assessed, the late gadolinium enhancement, stress-inducible regional wall motion abnormalities, perfusion defects and peak exercise cardiac index percentile-rank were independently associated with FFR-positive CAD. Indeed, this multiparametric approach offered the highest incremental diagnostic value compared to a clinical risk model (χ2 for the diagnosis of FFR-positive increased from 7.6 to 55.9; P < 0.001) and excellent performance [c-statistic area under the curve 0.97 (95% CI: 0.94–1.00)] in discriminating between FFR-normal and FFR-positive patients. Conclusion: The study demonstrates the clinical potential of using in-scanner multiparametric ExCMR to accurately diagnose CAD. Trial registration: ClinicalTrials.gov, NCT03217227, Registered 11 July 2017–Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03217227?id=NCT03217227&draw=2&rank=1&load=cart
dc.publisherSpringer Science and Business Media LLC
dc.sourceElements
dc.subjectCardiovascular magnetic resonance
dc.subjectCoronary artery disease
dc.subjectExercise stress
dc.subjectFractional flow reserve
dc.subjectSupine cycle ergometer
dc.subjectAged
dc.subjectBicycling
dc.subjectCoronary Angiography
dc.subjectCoronary Artery Disease
dc.subjectExercise Test
dc.subjectFemale
dc.subjectFractional Flow Reserve, Myocardial
dc.subjectHumans
dc.subjectMagnetic Resonance Imaging, Cine
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPerfusion Imaging
dc.subjectPredictive Value of Tests
dc.subjectProspective Studies
dc.subjectReproducibility of Results
dc.subjectSingapore
dc.typeArticle
dc.date.updated2022-06-07T01:39:28Z
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.contributor.departmentDEAN'S OFFICE (DUKE-NUS MEDICAL SCHOOL)
dc.description.doi10.1186/s12968-021-00705-8
dc.description.sourcetitleJournal of Cardiovascular Magnetic Resonance
dc.description.volume23
dc.description.issue1
dc.description.page17-
dc.published.statePublished
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