January 15, 2020JACC. Cardiovascular imagingOpen Access

High-Resolution Late Gadolinium Enhancement Magnetic Resonance for the Diagnosis of Myocardial Infarction With Nonobstructed Coronary Arteries

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Why the study?

CMR is pivotal for diagnosing MINOCA, but results remain inconclusive in a significant number of patients by being negative or uncertain.

Does high-resolution late gadolinium enhancement (LGE) imaging improve diagnostic yield compared to conventional CMR in patients with MINOCA?

Structured PICO

Does high-resolution late gadolinium enhancement (LGE) imaging improve diagnostic yield compared to conventional CMR in patients with MINOCA?

Population

229 consecutive patients categorized as having MINOCA after blood testing, electrocardiography, coronary angiography, and echocardiography (mean age 56 ± 17 years, 45% women).

Intervention

High-resolution (HR) late gadolinium enhancement (LGE) imaging using a 3-dimensional respiratory-navigated free-breathing method (voxel size 1.25 × 1.25 × 2.5 mm) added to conventional CMR.

Comparator

Conventional CMR alone (including cine, T2-weighted, first-pass perfusion, and conventional breath-held LGE imaging).

Outcome

Diagnostic yield (changes in final diagnosis and rate of inconclusive final diagnosis retained after reviewing conventional CMR compared with those retained after the addition of HR LGE imaging).surrogate

High-resolution LGE imaging significantly improves diagnostic yield and reduces inconclusive findings in patients with MINOCA compared to conventional CMR.

Authors

PLPierre-François LintingreClinique du Sport HNHubert NivetImagerie Médicale et Radiothérapie Drôme Ardèche SCStéphanie Clément-GuinaudeauCentre Hospitalier Universitaire de Bordeaux

Discussion

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Implication

May enhance diagnostic yield in MINOCA; leaves open whether adoption improves outcomes or warrants routine use.

Cite This Study

Lintingre et al. (2020) studied this question.

synapsesocial.com/papers/69f1a10510fa38abb3d237ac https://doi.org/10.1016/j.jcmg.2019.11.020

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