Cardiovascular magnetic resonance (CMR) stress perfusion testing is of great utility in the detection of coronary artery disease (CAD) in women, US and German researchers report in the July issue of JACC: Cardiovascular Imaging.

Dr. Igor Klem of Duke University Medical Center, Durham, North Carolina and colleagues studied 147 women with chest pain or other symptoms suggestive of CAD.

The CMR test consisted of "cine rest function, adenosine-stress and rest perfusion, and delayed-enhancement CMR infarction imaging."
CMR was completed in 136 women, and 37 (27%) had CAD on coronary angiography. For the diagnosis of CAD, using stenoses of 70% or greater as a cut-off point, the CMR stress test had a sensitivity of 84%, a specificity of 88% and an accuracy of 87%.

When the stenosis cut-off point was reduced to 50%, the accuracy fell to 82%. Sensitivity was lower in women with single-vessel disease (71%) compared to those with multi-vessel disease (100%) and for those with left ventricular mass of 97g or less (69% versus 95%).

Dr. Klem stated that with this test areas of the myocardium can be identified that are inadequately supplied with blood due to coronary artery disease, and see damaged tissue due to myocardial infarction with an unprecedented accuracy, and the consequences on heart function.

He said that the test has been performed at Duke since 2002 and several institutions in the US and Europe have since adopted the procedure.

JACC: Cardiovascular Imaging 2008;1:436-445.

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