Project Title

Optimized algorithm for quantification of absolute myocardial blood flow derived from stress perfusion cardiac magnetic resonance imaging to diagnose obstructive coronary artery disease.

Background

In patients with suspected obstructive CAD, stress perfusion CMR with additional measurements of absolute MBF is guideline-endorsed. However, absolute MBF by CMR correlates poorly to estimates by other imaging techniques and invasive physiology, and the diagnostic accuracy of absolute MBF is only moderate. The presence of cardiovascular risk factors (RF) and different measures of coronary and cardiac morphology could impact absolute MBF and hence diagnostic accuracy.

Aim

To improve the diagnosis of patients with suspected obstructive CAD by developing an optimized algorithm for quantification of absolute MBF derived from stress perfusion CMR.

Design

In an existing cohort of prospectively enrolled chest pain patients, logistic regression analyses are used to identify specific RFs and measures of coronary and cardiac morphology that impact absolute values of MBF from CMR. Based on these experiences, a novel dual-sequence protocol for stress perfusion CMR is developed in collaboration with international partners and implemented and tested in a planned large-scale prospective clinical trial for improved diagnosis of obstructive CAD by absolute MBF.