Key result
District hospital adenosine stress CMR proves feasible but interpretation remains challenging without reference center collaboration.
Why the study?
Stress pCMR is recommended for suspected obstructive CAD, but prior studies were mostly conducted in high-volume university hospitals, leaving the feasibility of establishing such a service in a district hospital unknown.
Does local interpretation of adenosine stress pCMR in a district hospital agree with an experienced reference CMR center in patients with intermediate pretest probability of CAD?
Observational (n=113)
No
Does local interpretation of adenosine stress pCMR in a district hospital agree with an experienced reference CMR center in patients with intermediate pretest probability of CAD?
While performing stress pCMR in a district hospital is feasible, local interpretation is challenging and requires close collaboration with an experienced reference center.
Supports district hospital stress pCMR feasibility; leaves open whether local interpretation achieves reference accuracy without collaboration.
Background: The European Society of Cardiology has published updated guidelines regarding pathways for diagnosis and management of obstructive coronary artery disease (CAD). Non-invasive functional assessment, for example, by stress perfusion cardiac magnetic resonance (stress pCMR) is recommended in patients with intermediate pretest probability of disease. Previous pCMR studies were mainly performed in high volume university hospitals with experienced radiologists or cardiologists interpreting the images. Purpose: The aim of the present study was to evaluate the feasibility of establishing a stress pCMR imaging service in a district hospital. Material and Methods: One hundred and thirteen patients with intermediate pretest probability of CAD referred for single-photon emission computed tomography (SPECT) at the regional hospital also underwent adenosine stress pCMR locally. The diagnostic analysis was compared to that of an experienced cardiac magnetic resonance (CMR) center serving as a reference. Results: = 0.34 and 0.51). No improvement in agreement between reference reader and local reader during the study was demonstrated. Conclusion: CMR is feasible in patients with intermediate pretest probability of obstructive CAD in the setting of a district hospital. However, as opposed to infarct detection with LGE, the interpretation of stress pCMR was more challenging. To establish this method, we suggest obtaining experience in close collaboration with a reference CMR center.
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Gleditsch et al. (2023) conducted an observational in Obstructive coronary artery disease (CAD) (n=113). Adenosine stress perfusion cardiac magnetic resonance (stress pCMR) vs. Experienced cardiac magnetic resonance (CMR) center was evaluated on Diagnostic agreement between local reader and reference reader. Adenosine stress perfusion cardiac magnetic resonance imaging is feasible in a district hospital, though interpretation is challenging without close collaboration with a reference center.
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