Leif-Christopher Engel1, Ulf Landmesser2, Kevin Gigengack3, Thomas Wurster3, Constantina Manes3, Georg Girke3, Milosz Jaguszewski3, Carsten Skurk3, David M Leistner3, Alexander Lauten3, Andreas Schuster4, Bernd Hamm5, Rene M Botnar6, Marcus R Makowski7, Boris Bigalke8. 1. Klinik für Kardiologie, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany. 2. Klinik für Kardiologie, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany. 3. Klinik für Kardiologie, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany. 4. Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, Australia; Department of Cardiology and Pulmonology, German Centre for Cardiovascular Research Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK) Partner Site, Göttingen, Germany. 5. Klinik für Radiologie, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany. 6. Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom; Pontificia Universidad Católica de Chile Escuela de Ingeniería, Santiago, Chile. 7. Klinik für Radiologie, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany. Electronic address: marcus.makowski@charite.de. 8. Klinik für Kardiologie, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany. Electronic address: boris.bigalke@charite.de.
Abstract
OBJECTIVES: This study sought to investigate the potential of the noninvasive albumin-binding probe gadofosveset-enhanced cardiac magnetic resonance (GE-CMR) for detection of coronary plaques that can cause acute coronary syndromes (ACS). BACKGROUND: ACS are frequently caused by rupture or erosion of coronary plaques that initially do not cause hemodynamically significant stenosis and are therefore not detected by invasive x-ray coronary angiography (XCA). METHODS: A total of 25 patients with ACS or symptoms of stable coronary artery disease underwent GE-CMR, clinically indicated XCA, and optical coherence tomography (OCT) within 24 h. GE-CMR was performed approximately 24 h following a 1-time application of gadofosveset-trisodium. Contrast-to-noise ratio (CNR) was quantified within coronary segments in comparison with blood signal. RESULTS: A total of 207 coronary segments were analyzed on GE-CMR. Segments containing a culprit lesion in ACS patients (n = 11) showed significant higher signal enhancement (CNR) following gadofosveset-trisodium application than segments without culprit lesions (n = 196; 6.1 [3.9 to 16.5] vs. 2.1 [0.5 to 3.5]; p < 0.001). GE-CMR was able to correctly identify culprit coronary lesions in 9 of 11 segments (sensitivity 82%) and correctly excluded culprit coronary lesions in 162 of 195 segments (specificity 83%). Additionally, segmented areas of thin-cap fibroatheroma (n = 22) as seen on OCT demonstrated significantly higher CNR than segments without coronary plaque or segments containing early atherosclerotic lesions (n = 185; 9.2 [3.3 to 13.7] vs. 2.1 [0.5 to 3.4]; p = 0.001). CONCLUSIONS: In this study, we demonstrated for the first time the noninvasive detection of culprit coronary lesions and thin-cap fibroatheroma of the coronary arteries in vivo by using GE-CMR. This method may represent a novel approach for noninvasive cardiovascular risk prediction.
OBJECTIVES: This study sought to investigate the potential of the noninvasive albumin-binding probe gadofosveset-enhanced cardiac magnetic resonance (GE-CMR) for detection of coronary plaques that can cause acute coronary syndromes (ACS). BACKGROUND: ACS are frequently caused by rupture or erosion of coronary plaques that initially do not cause hemodynamically significant stenosis and are therefore not detected by invasive x-ray coronary angiography (XCA). METHODS: A total of 25 patients with ACS or symptoms of stable coronary artery disease underwent GE-CMR, clinically indicated XCA, and optical coherence tomography (OCT) within 24 h. GE-CMR was performed approximately 24 h following a 1-time application of gadofosveset-trisodium. Contrast-to-noise ratio (CNR) was quantified within coronary segments in comparison with blood signal. RESULTS: A total of 207 coronary segments were analyzed on GE-CMR. Segments containing a culprit lesion in ACS patients (n = 11) showed significant higher signal enhancement (CNR) following gadofosveset-trisodium application than segments without culprit lesions (n = 196; 6.1 [3.9 to 16.5] vs. 2.1 [0.5 to 3.5]; p < 0.001). GE-CMR was able to correctly identify culprit coronary lesions in 9 of 11 segments (sensitivity 82%) and correctly excluded culprit coronary lesions in 162 of 195 segments (specificity 83%). Additionally, segmented areas of thin-cap fibroatheroma (n = 22) as seen on OCT demonstrated significantly higher CNR than segments without coronary plaque or segments containing early atherosclerotic lesions (n = 185; 9.2 [3.3 to 13.7] vs. 2.1 [0.5 to 3.4]; p = 0.001). CONCLUSIONS: In this study, we demonstrated for the first time the noninvasive detection of culprit coronary lesions and thin-cap fibroatheroma of the coronary arteries in vivo by using GE-CMR. This method may represent a novel approach for noninvasive cardiovascular risk prediction.
Authors: Maaike van den Boomen; Hanne B Kause; Hans C van Assen; Patricia Y W Dankers; Carlijn V C Bouten; Katrien Vandoorne Journal: Sci Rep Date: 2019-12-18 Impact factor: 4.379
Authors: Reza Hajhosseiny; Camila Munoz; Gastao Cruz; Ramzi Khamis; Won Yong Kim; Claudia Prieto; René M Botnar Journal: Front Cardiovasc Med Date: 2021-08-17
Authors: Leif-Christopher Engel; Ulf Landmesser; Youssef S Abdelwahed; Milosz Jaguszewski; Kevin Gigengack; Thomas-Heinrich Wurster; Carsten Skurk; Costantina Manes; Andreas Schuster; Michel Noutsias; Bernd Hamm; Rene M Botnar; Marcus R Makowski; Boris Bigalke Journal: PLoS One Date: 2020-01-31 Impact factor: 3.240