Coronary flow reserve evaluated by phase-contrast cine cardiovascular magnetic resonance imaging of coronary sinus: a meta-analysis

Journal of Cardiovascular Magnetic Resonance

Research

Nobuyuki Horita¹  Mai Azuma²  Masanori Ito³  Shingo Kato⁴  Toshiki Tanigaki⁴  Daisuke Utsunomiya⁴ 

[1] Chemotherapy Center, Yokohama City University Graduate School of Medicine, Yokohama, Japan;Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan;Department of Diagnostic Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan;Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan;

关键词: Coronary flow reserve;    Coronary sinus;    Coronary artery disease;    Phase-contrast;    Meta-analysis;   

DOI  :  10.1186/s12968-023-00912-5

 received in 2022-06-30, accepted in 2023-01-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPhase-contrast cine cardiovascular magnetic resonance (CMR) of the coronary sinus has emerged as a non-invasive method for measuring coronary sinus blood flow and coronary flow reserve (CFR). However, its clinical utility has not yet been established. Here we performed a meta-analysis to clarify the clinical value of CMR-derived CFR in various cardiovascular diseases.MethodsAn electronic database search was performed of PubMed, Web of Science Core Collection, Cochrane Advanced Search, and EMBASE. We compared the CMR-derived CFR of various cardiovascular diseases (stable coronary artery disease [CAD], hypertrophic cardiomyopathy [HCM], dilated cardiomyopathy [DCM]) and control subjects. We assessed the prognostic value of CMR-derived CFR for predicting major adverse cardiac events (MACE) in patients with stable CAD.ResultsA total of 47 eligible studies were identified. The pooled CFR from our meta-analysis was 3.48 (95% confidence interval [CI], 2.98–3.98) in control subjects, 2.50 (95% CI, 2.38–2.61) in stable CAD, 2.01 (95% CI, 1.70–2.32) in cardiomyopathies (HCM and DCM). The meta-analysis showed that CFR was significantly reduced in stable CAD (mean difference [MD] = −1.48; 95% CI, −1.78 to −1.17; p < 0.001; I2 = 0%; p for heterogeneity = 0.33), HCM (MD = −1.20; 95% CI, −1.63 to −0.77; p < 0.001; I2 = 0%; p for heterogeneity = 0.49), and DCM (MD = −1.53; 95% CI, −1.93 to −1.13; p < 0.001; I2 = 0%; p for heterogeneity = 0.45). CMR-derived CFR was an independent predictor of MACE for patients with stable CAD (hazard ratio = 0.52 per unit increase; 95% CI, 0.37–0.73; p < 0.001; I2 = 84%, p for heterogeneity < 0.001).ConclusionsCMR-derived CFR was significantly decreased in cardiovascular diseases, and a decreased CFR was associated with a higher occurrence of MACE in patients with stable CAD. These results suggest that CMR-derived CFR has potential for the pathological evaluation of stable CAD, cardiomyopathy, and risk stratification in CAD.

【 授权许可】

CC BY   
© The Author(s) 2023

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