CAPABILITIES OF CARDIAC MAGNETIC RESONANCE IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF ACUTE CORONARY SYNDROME IN PATIENTS WITH NONOBSTRUCTIVE CORONARY ATHEROSCLEROSIS
https://doi.org/10.29001/2073-8552-2017-32-1-39-46
Abstract
The aim of the study was to evaluate the capabilities of cardiac MRI in the differential diagnosis of acute coronary syndrome (ACS) in patients with nonobstructive coronary atherosclerosis. Material and Methods. This nonrandomized open controlled study was registered on ClinicalTrials.gov: NCT02655718. This article presents the results of the subanalysis of the study. Analysis included data of ACS patients admitted to the Emergency Department of Cardiology Research Institute in 2015–2016. Inclusion criteria were nonobstructive coronary atherosclerosis (normal coronary arteries / plaques <50%), confirmed by invasive coronary angiography, age e”18 years at the time of randomization. The exclusion criteria were previous revascularization of the coronary arteries. 22 patients underwent cardiac MRI. Results. Among 604 individuals who were hospitalized with ACS to the Emergency Department of Cardiology Research Institute in 2015–2016, 3.8% (23) patients had nonobstructive coronary atherosclerosis confirmed by coronary angiography. 22 patients underwent cardiac MRI. Acute myocardial infarction was diagnosed in 56% (13) of cases; unstable angina was diagnosed in 13% (3) of cases; and 1/3 of cases had pseudocoronary scenario of myocarditis. Conclusions. The proportion of patients with nonobstructive coronary atherosclerosis was 3.8%. Cardiac MRI can be used for differential diagnosis of ACS in patients with nonobstructive coronary atherosclerosis.
About the Authors
S. B. Gomboeva
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
National Research Tomsk State University
Russian Federation
Russian Federation
V. V. Ryabov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
National Research Tomsk State University
Siberian State Medical University
Russian Federation
Russian Federation
T. A. Shelkovnikova
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
W. Yu. Ussov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
A. E. Baev
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
References
1. Гомбожапова А.Э., Роговская Ю.В., Рябова Т.Р. и др. Случай псевдокоронарного варианта клинического течения воспалительной вирусной кардиомиопатии // Сиб. мед. журн. (Томск). – 2015. – Т. 30(4). – С. 60–65.
2. Planer D., Mehran R., Ohman E.M. et al. Prognosis of рatients with non–ST-segment– elevation myocardial infarction and nonobstructive coronary artery disease propensity-matched analysis from the acute catheterization and urgent intervention triage strategy trial // Circulation. – 2014. – Vol. 7. – P. 285– 293.
3. Tornvall P., Gerbaud E., Behaghel A. et al. Myocarditis or “true” infarction by cardiac magnetic resonance in patients with a clinical diagnosis of myocardial infarction without obstructive coronary disease // Atherosclerosis. – 2015. – Vol. 241(1). – P. 87–91.
4. Pasupathy S., Air T.M., Dreyer R.P. et al. Systematic Review of Patients Presenting With Suspected Myocardial Infarction and Nonobstructive Coronary Arteries // Circulation. – 2015. – Vol. 131. – P. 861–870.
5. Agewall S., Beltrame J.F., Reynolds H.R. et al. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries // Eur. Heart J. [Electronic resource] – doi:10.1093/eurheartj/ehw149 (дата обращения 24.11.2016).
6. Третье универсальное определение инфаркта миокарда // Рос. кардиол. журн. – 2013. – № 2(100).
7. Pasupathy S., Tavella R., Beltrame J.F. The What, When, Who, Why, How and Where of Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) // Circulation. – 2016. – No. 80. – P. 11–16.
8. Rajiah P., Desai M.Y., Kwon D. et al. MR Imaging of Myocardial Infarction // RSNA. – 2013. – P. 1383–1412.
9. Roffi M., Patrono C., Collet J.P. et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation [Electronic resource] // Eur. Heart J. – 2015. – Doi:10.1093/eurheartj/ehv320.
10. Pilgrim T.M., Wyss T.R. Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: A systematic review // Int. J. Cardiol. – 2008. – No. 124(3). – P. 283–292.
11. Caforio A.L., Pankuweit S., Arbustini E. et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases // Eur. Heart J. – 2013. – No. 34(33). – P. 2636–2648.
12. De Ferrari G.M., Fox K.A., White J.A. et al. Outcomes among non-ST-segment elevation acute coronary syndromes patients with no angiographically obstructive coronary artery disease: observations from 37,101 patients // Eur. Heart J. Acute Cardiovasc. Care. – 2014. – Vol. 3(1). – P. 37–45.
13. Esposito A., Francone M., Faletti R. Lights and shadows of cardiac magnetic resonance imaging in acute myocarditis // Insights Imaging. – 2016. – No. 7. – P. 99–110.
14. Ferreira V.M., Piechnik S.K., Dall’Armellina E. T1-mapping for the diagnosis of acute myocarditis using CMR// JACC Cardiovasc. Imaging. – 2013. – No. 6(10). – P. 1048–1058.
15. Herzog B., Greenwood J., Plein S. CMR Pocket Guide, 2013 [Electronic resource]. – URL: https://www.escardio.org/static_file/Escardio/Subspecialty/EACVI/CMR-guide-2013.pdf (дата обращения 01.12.2016).
16. Mulia E., Wicaksono S.H., Kasim M. Role of cardiac MRI in acute myocardial infarction // Med. J. Indones. – 2013. – Vol. 22. – P. 46–53.
17. Стукалова О.В., Староверов И.И., Жукова Н.А. и др. Магнитно-резонансная томография сердца у больных инфарктом миокарда // Кубанский научн. мед. вестн. – 2010. – № 6. – С. 134–139.
Review
For citations:
Gomboeva S.B., Ryabov V.V., Shelkovnikova T.A., Ussov W.Yu., Baev A.E. CAPABILITIES OF CARDIAC MAGNETIC RESONANCE IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF ACUTE CORONARY SYNDROME IN PATIENTS WITH NONOBSTRUCTIVE CORONARY ATHEROSCLEROSIS. Siberian Journal of Clinical and Experimental Medicine. 2017;32(1):39-46. (In Russ.) https://doi.org/10.29001/2073-8552-2017-32-1-39-46
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