Key result
A 10-minute 3D-MRCA protocol yielded technically satisfactory images in 93% of subjects and successfully identified malignant coronary artery anomalies in 1% of healthy athletes and non-athletes.
Why the study?
Can a 10-minute free-breathing 3D-MRCA be used to screen for proximal coronary artery anomalies in healthy athletes and non-athletes?
Cross-Sectional (n=360)
Blinded to participant characteristics
No
Can a 10-minute free-breathing 3D-MRCA be used to screen for proximal coronary artery anomalies in healthy athletes and non-athletes?
A 10-minute free-breathing 3D-MRCA can be effectively added to standard cardiac MRI protocols to screen young athletes and non-athletes for anomalous proximal coronary arteries without radiation exposure.
May support adding brief 3D-MRCA to cardiac MRI for CAA screening in young adults; hypothesis-generating and requires prospective outcome trials.
Under 35 years of age, 14% of sudden cardiac death in athletes is caused by a coronary artery anomaly (CAA). Free-breathing 3-dimensional magnetic resonance coronary angiography (3D-MRCA) has the potential to screen for CAA in athletes and non-athletes as an addition to a clinical cardiac MRI protocol. A 360 healthy men and women (207 athletes and 153 non-athletes) aged 18-60 years (mean age 31 +/- 11 years, 37% women) underwent standard cardiac MRI with an additional 3D-MRCA within a maximum of 10 min scan time. The 3D-MRCA was screened for CAA. A 335 (93%) subjects had a technically satisfactory 3D-MRCA of which 4 (1%) showed a malignant variant of the right coronary artery (RCA) origin running between the aorta and the pulmonary trunk. Additional findings included three subjects with ventral rotation of the RCA with kinking and possible proximal stenosis, one person with additional stenosis and six persons with proximal myocardial bridging of the left anterior descending coronary artery. Coronary CT-angiography (CTA) was offered to persons with CAA (the CAA was confirmed in three, while one person declined CTA) and stenosis (the ventral rotation of the RCA was confirmed in two but without stenosis, while two people declined CTA). Overall 3D MRCA quality was better in athletes due to lower heart rates resulting in longer end-diastolic resting periods. This also enabled faster scan sequences. A 3D-MRCA can be used as part of the standard cardiac MRI protocol to screen young competitive athletes and non-athletes for anomalous proximal coronary arteries.
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Prakken et al. (2010) conducted a cross-sectional in Coronary Artery Anomalies (n=360). 3-dimensional MR coronary angiography (3D-MRCA) was evaluated on Technically satisfactory 3D-MRCA scans for coronary artery anomaly assessment. A 10-minute 3D-MRCA protocol yielded technically satisfactory images in 93% of subjects and successfully identified malignant coronary artery anomalies in 1% of healthy athletes and non-athletes.
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