Abstract Aims Quantitative stress perfusion (QP) cardiac magnetic resonance (CMR) can be performed using the dual sequence (DS) or dual bolus (DB) technique. DS does not require additional contrast and image acquisition but needs a research sequence. DB can be performed on all MRI scanners with standard perfusion sequences but requires additional contrast injection and image acquisition. Our aim was to compare the prognostic significance of DB and DS. Methods 61.2% male) were recruited. Median follow-up was 743 days. 54 events were documented. All QP CMR variables demonstrated significance in univariate Cox regression DB stress MBF (HR=0.53 (95%CI:0.35-0.78)), DB MPR (HR=0.38 (95%CI:0.22-0.66)), DS stress MBF (HR=0.27 (95%CI:0.18-0.40)) and DS MPR (HR=0.19 (95%CI:0.13-0.29)). On multivariable Cox regression models, only DB MPR, DS MBF and DS MPR remained significant for MACE (HR=0.50 (95%CI:0.28-0.89), HR=0.35 (95%CI:0.23-0.53); HR=0.23 (95%CI 0.15-0.36), respectively). Harrell’s C-index of DS MPR and DS stress MBF showed significantly better prognostication than their DB counterparts (p0.001 and p=0.012 respectively). Conclusion In this blinded comparison, DS stress MBF and MPR demonstrated better prognostication than DB stress MBF and MPR. Our findings support DS as the preferred approach where available.
Leung et al. (Wed,) studied this question.
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