Cardiac magnetic resonance in patients with elevated troponin and normal coronary angiography

Subir Bhatia, Christopher Anstine, Allan S Jaffe, Bernard J. Gersh, Krishnaswamy Chandrasekaran, Thomas A. Foley, David Hodge, Nandan S. Anavekar

Research output: Contribution to journalArticle

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Abstract

Background: Invasive angiography in the setting of cardiac troponin elevation may reveal non-obstructive coronary arteries leading to uncertainty in diagnosis. Cardiac MR (CMR) may aid in diagnosis, however, the spectrum of diagnostic findings in the patient presenting with symptoms of cardiac ischaemia, elevated cardiac biomarkers and a negative invasive coronary angiogram is yet to be completely described. Methods: We queried the Mayo Clinic, Rochester inpatient record from 1 January 2000 to 31 December 2016 to identify patients who: (1) had an elevated troponin T during admission, (2) underwent coronary angiography within 30 days of troponin T elevation which was considered negative for obstructive coronary arterial disease and (3) underwent CMR within 30 days of troponin T elevation. CMR diagnoses were classified as either (1) myocarditis, (2) small area myocardial infarction, (3) stress cardiomyopathy, (4) non-ischaemic cardiomyopathy or (5) normal. Results: Of 215 patients, the spectrum of disease seen on CMR was myocarditis (32%), small area infarction (22%), non-ischaemic cardiomyopathy (20%) and stress cardiomyopathy (9.3%). Conclusion: In the largest single-centre study assessing the role of CMR in patients admitted with elevated troponin T with a non-obstructive coronary disease on an angiogram, small area infarction was seen in 22% of patients.

Original languageEnglish (US)
JournalHeart
DOIs
StatePublished - Jan 1 2019

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Troponin
Coronary Angiography
Troponin T
Magnetic Resonance Spectroscopy
Takotsubo Cardiomyopathy
Angiography
Myocarditis
Cardiomyopathies
Infarction
Coronary Disease
Uncertainty
Inpatients
Coronary Vessels
Ischemia
Biomarkers
Myocardial Infarction

Keywords

  • acute myocardial infarction
  • cardiac magnetic resonance (cmr) imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bhatia, S., Anstine, C., Jaffe, A. S., Gersh, B. J., Chandrasekaran, K., Foley, T. A., ... Anavekar, N. S. (2019). Cardiac magnetic resonance in patients with elevated troponin and normal coronary angiography. Heart. https://doi.org/10.1136/heartjnl-2018-314631

Cardiac magnetic resonance in patients with elevated troponin and normal coronary angiography. / Bhatia, Subir; Anstine, Christopher; Jaffe, Allan S; Gersh, Bernard J.; Chandrasekaran, Krishnaswamy; Foley, Thomas A.; Hodge, David; Anavekar, Nandan S.

In: Heart, 01.01.2019.

Research output: Contribution to journalArticle

Bhatia, Subir ; Anstine, Christopher ; Jaffe, Allan S ; Gersh, Bernard J. ; Chandrasekaran, Krishnaswamy ; Foley, Thomas A. ; Hodge, David ; Anavekar, Nandan S. / Cardiac magnetic resonance in patients with elevated troponin and normal coronary angiography. In: Heart. 2019.
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