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Functional significance of Blood Oxygen Level Dependent (BOLD) imaging in patients with coronary artery disease - a validation study using fractional flow reserve

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Blood oxygen level-dependent (BOLD) cardiac MRI (CMR) uses the signal generated by endogenous hemoglobin in the blood supply to directly measure tissue oxygenation... Therefore it may be useful as a non-contrast enhanced, non-invasive method to detect the presence of myocardial ischemia in patients suspected of having coronary artery disease (CAD)... The aim of this study was to validate whether BOLD-sensitive CMR images can detect and quantify alterations in myocardial oxygen levels in patients with CAD, in comparison to the gold standard of fractional flow reserve (FFR)... Bland-Altman analysis was used to assess the level of agreement between all segments analyzed by two blinded readers... Twenty-eight patients totaling 147 myocardial segments were available for analysis. 73 segments were excluded, with 66% of these being apical... The remaining 74 segments equated to 22 patients (60 +/- 9y, 19 males), eight of these had a normal FFR (≥ 0.80) and 14 had FFR values <0.80... Mean BOLD SI percent change was significantly less in patients with abnormal FFR values (-4.62 +/- 2.28% SEM), in comparison to patients with normal FFR values (8.54 +/- 3.08 % SEM); p=0.003. (See Figure 1 and 2)... The Bland-Altman analysis indicated that the 95% limits of agreement between the two readers ranged from -23.6% to 27.8% (Figure 3)... Our pilot data indicate that BOLD-sensitive CMR may allow for selectively identifying hemodynamically relevant coronary artery stenoses based on a blunted hyperemic response to adenosine... Image quality (particularly in apical segments) remains a significant limitation of the BOLD technique, with this reflected in suboptimal interobserver variability... Most excluded segments were from early studies, suggesting improved acquisition quality with experience.

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Bland-Altman analysis for inter-observer variability
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Figure 3: Bland-Altman analysis for inter-observer variability

Mentions: Twenty-eight patients totaling 147 myocardial segments were available for analysis. 73 segments were excluded, with 66% of these being apical. The remaining 74 segments equated to 22 patients (60 +/- 9y, 19 males), eight of these had a normal FFR (≥ 0.80) and 14 had FFR values <0.80. Mean BOLD SI percent change was significantly less in patients with abnormal FFR values (-4.62 +/- 2.28% SEM), in comparison to patients with normal FFR values (8.54 +/- 3.08 % SEM); p=0.003. (See Figure 1 and 2). The Bland-Altman analysis indicated that the 95% limits of agreement between the two readers ranged from -23.6% to 27.8% (Figure 3).


Functional significance of Blood Oxygen Level Dependent (BOLD) imaging in patients with coronary artery disease - a validation study using fractional flow reserve
Bland-Altman analysis for inter-observer variability
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3106470&req=5

Figure 3: Bland-Altman analysis for inter-observer variability
Mentions: Twenty-eight patients totaling 147 myocardial segments were available for analysis. 73 segments were excluded, with 66% of these being apical. The remaining 74 segments equated to 22 patients (60 +/- 9y, 19 males), eight of these had a normal FFR (≥ 0.80) and 14 had FFR values <0.80. Mean BOLD SI percent change was significantly less in patients with abnormal FFR values (-4.62 +/- 2.28% SEM), in comparison to patients with normal FFR values (8.54 +/- 3.08 % SEM); p=0.003. (See Figure 1 and 2). The Bland-Altman analysis indicated that the 95% limits of agreement between the two readers ranged from -23.6% to 27.8% (Figure 3).

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Blood oxygen level-dependent (BOLD) cardiac MRI (CMR) uses the signal generated by endogenous hemoglobin in the blood supply to directly measure tissue oxygenation... Therefore it may be useful as a non-contrast enhanced, non-invasive method to detect the presence of myocardial ischemia in patients suspected of having coronary artery disease (CAD)... The aim of this study was to validate whether BOLD-sensitive CMR images can detect and quantify alterations in myocardial oxygen levels in patients with CAD, in comparison to the gold standard of fractional flow reserve (FFR)... Bland-Altman analysis was used to assess the level of agreement between all segments analyzed by two blinded readers... Twenty-eight patients totaling 147 myocardial segments were available for analysis. 73 segments were excluded, with 66% of these being apical... The remaining 74 segments equated to 22 patients (60 +/- 9y, 19 males), eight of these had a normal FFR (≥ 0.80) and 14 had FFR values <0.80... Mean BOLD SI percent change was significantly less in patients with abnormal FFR values (-4.62 +/- 2.28% SEM), in comparison to patients with normal FFR values (8.54 +/- 3.08 % SEM); p=0.003. (See Figure 1 and 2)... The Bland-Altman analysis indicated that the 95% limits of agreement between the two readers ranged from -23.6% to 27.8% (Figure 3)... Our pilot data indicate that BOLD-sensitive CMR may allow for selectively identifying hemodynamically relevant coronary artery stenoses based on a blunted hyperemic response to adenosine... Image quality (particularly in apical segments) remains a significant limitation of the BOLD technique, with this reflected in suboptimal interobserver variability... Most excluded segments were from early studies, suggesting improved acquisition quality with experience.

No MeSH data available.