Shazia T Hussain1, Geraint Morton2, Kalpa De Silva3, Roy Jogiya4, Andreas Schuster5, Matthias Paul6, Divaka Perera3, Eike Nagel7. 1. Cardiology Department, Papworth Hospital NHS trust, Papworth Everard, Cambridgeshire, UK. shaziathussain@icloud.com. 2. Portsmouth Hospitals NHS Trust, Portsmouth, UK. 3. Cardiovascular Division, King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, The Rayne Institute, London, UK. 4. Division of Imaging Sciences, King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, The Rayne Institute, London, UK. 5. Department of Cardiology and Pneumonology, Georg-August-University Gottingen and German Centre for Cardiovascular Research (DZHK, Partner Site Gottingen), Gottingen, Germany. 6. Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. 7. DZHK Centre for Cardiovascular Imaging, University Hospital, Frankfurt/Main, Germany.
Abstract
AIMS: This study assesses the relationship between classical anatomical jeopardy scores, functional jeopardy scores (combined anatomical and haemodynamic data), and the extent of ischaemia identified on cardiovascular magnetic resonance (CMR) perfusion imaging. METHODS AND RESULTS: In 42 patients with stable angina and suspected coronary artery disease (CAD), CMR perfusion imaging was performed. Fractional Flow Reserve (FFR) was measured in vessels with ≥50 % stenosis. The APPROACH and BCIS jeopardy scores were calculated based on QCA results with both a 70 % (APP70 and BCIS70) and a 50 % stenosis (APP50, and BCIS50) used as the threshold for significance, as well as after integration of FFR and compared with the extent of ischaemia identified on CMR. The correlation between the extent of ischaemia measured by CMR and the anatomical jeopardy scores was moderate (APPROACH: r = 0.58; BCIS: r = 0.48, p = 0.001). Integrating physiological information improved this significantly to r = 0.82, p = 0.0001 for APPROACH and r = 0.82, p = 0.0001 for BCIS scores (z-statistic = -2.04, p = 0.04; z-statistic = -2.63, p = 0.009). In relation to CMR, the APPROACH and BCIS scores overestimated the volume of ischaemic myocardium by 29.2 and 25.2 %, respectively, which was reduced to 12.8 and 12 % after integrating functional data. CONCLUSIONS: Anatomical and functional jeopardy scores overestimate ischaemic burden when compared to CMR. Integrating physiological information from FFR to generate a functional score improves ischaemic burden estimation.
AIMS: This study assesses the relationship between classical anatomical jeopardy scores, functional jeopardy scores (combined anatomical and haemodynamic data), and the extent of ischaemia identified on cardiovascular magnetic resonance (CMR) perfusion imaging. METHODS AND RESULTS: In 42 patients with stable angina and suspected coronary artery disease (CAD), CMR perfusion imaging was performed. Fractional Flow Reserve (FFR) was measured in vessels with ≥50 % stenosis. The APPROACH and BCIS jeopardy scores were calculated based on QCA results with both a 70 % (APP70 and BCIS70) and a 50 % stenosis (APP50, and BCIS50) used as the threshold for significance, as well as after integration of FFR and compared with the extent of ischaemia identified on CMR. The correlation between the extent of ischaemia measured by CMR and the anatomical jeopardy scores was moderate (APPROACH: r = 0.58; BCIS: r = 0.48, p = 0.001). Integrating physiological information improved this significantly to r = 0.82, p = 0.0001 for APPROACH and r = 0.82, p = 0.0001 for BCIS scores (z-statistic = -2.04, p = 0.04; z-statistic = -2.63, p = 0.009). In relation to CMR, the APPROACH and BCIS scores overestimated the volume of ischaemic myocardium by 29.2 and 25.2 %, respectively, which was reduced to 12.8 and 12 % after integrating functional data. CONCLUSIONS: Anatomical and functional jeopardy scores overestimate ischaemic burden when compared to CMR. Integrating physiological information from FFR to generate a functional score improves ischaemic burden estimation.
Authors: Nico H J Pijls; Pepijn van Schaardenburgh; Ganesh Manoharan; Eric Boersma; Jan-Willem Bech; Marcel van't Veer; Frits Bär; Jan Hoorntje; Jacques Koolen; William Wijns; Bernard de Bruyne Journal: J Am Coll Cardiol Date: 2007-05-17 Impact factor: 24.094
Authors: Leslee J Shaw; Daniel S Berman; Michael H Picard; Matthias G Friedrich; Raymond Y Kwong; Gregg W Stone; Roxy Senior; James K Min; Rory Hachamovitch; Marielle Scherrer-Crosbie; Jennifer H Mieres; Thomas H Marwick; Lawrence M Phillips; Farooq A Chaudhry; Patricia A Pellikka; Piotr Slomka; Andrew E Arai; Ami E Iskandrian; Timothy M Bateman; Gary V Heller; Todd D Miller; Eike Nagel; Abhinav Goyal; Salvador Borges-Neto; William E Boden; Harmony R Reynolds; Judith S Hochman; David J Maron; Pamela S Douglas Journal: JACC Cardiovasc Imaging Date: 2014-06
Authors: R M Califf; H R Phillips; M C Hindman; D B Mark; K L Lee; V S Behar; R A Johnson; D B Pryor; R A Rosati; G S Wagner Journal: J Am Coll Cardiol Date: 1985-05 Impact factor: 24.094
Authors: Jayanth R Arnold; Theodoros D Karamitsos; William J van Gaal; Luca Testa; Jane M Francis; Paul Bhamra-Ariza; Ali Ali; Joseph B Selvanayagam; Steve Westaby; Rana Sayeed; Michael Jerosch-Herold; Stefan Neubauer; Adrian P Banning Journal: Circ Cardiovasc Interv Date: 2013-05-21 Impact factor: 6.546
Authors: Leslee J Shaw; Daniel S Berman; David J Maron; G B John Mancini; Sean W Hayes; Pamela M Hartigan; William S Weintraub; Robert A O'Rourke; Marcin Dada; John A Spertus; Bernard R Chaitman; John Friedman; Piotr Slomka; Gary V Heller; Guido Germano; Gilbert Gosselin; Peter Berger; William J Kostuk; Ronald G Schwartz; Merill Knudtson; Emir Veledar; Eric R Bates; Benjamin McCallister; Koon K Teo; William E Boden Journal: Circulation Date: 2008-02-11 Impact factor: 29.690
Authors: Geraint Morton; Amedeo Chiribiri; Masaki Ishida; Shazia T Hussain; Andreas Schuster; Andreas Indermuehle; Divaka Perera; Juhani Knuuti; Stacey Baker; Erik Hedström; Paul Schleyer; Michael O'Doherty; Sally Barrington; Eike Nagel Journal: J Am Coll Cardiol Date: 2012-09-19 Impact factor: 24.094
Authors: Andreas Seitz; Kai C Wollert; Gerd P Meyer; Jochen Müller-Ehmsen; Carsten Tschöpe; Andreas E May; Klaus Empen; Emmanuel Chorianopoulos; Benedikta Ritter; Jens Pirr; Lubomir Arseniev; Hans-Gert Heuft; Arnold Ganser; Eed Abu-Zaid; Hugo A Katus; Stephan B Felix; Meinrad P Gawaz; Heinz-Peter Schultheiss; Dennis Ladage; Johann Bauersachs; Heiko Mahrholdt; Simon Greulich Journal: Clin Res Cardiol Date: 2019-08-10 Impact factor: 5.460
Authors: Barry Hennigan; Colin Berry; Damien Collison; David Corcoran; Hany Eteiba; Richard Good; Margaret McEntegart; Stuart Watkins; John D McClure; Kenneth Mangion; Thomas Joseph Ford; Mark C Petrie; Stuart Hood; Paul Rocchiccioli; Aadil Shaukat; Mitchell Lindsay; Keith G Oldroyd Journal: Heart Date: 2020-02-29 Impact factor: 5.994