Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging

Leslee J. Shaw, Daniel S. Berman, Michael H. Picard, Matthias G. Friedrich, Raymond Y. Kwong, Gregg W. Stone, Roxy Senior, James K. Min, Rory Hachamovitch, Marielle Scherrer-Crosbie, Jennifer H. Mieres, Thomas H. Marwick, Lawrence M. Phillips, Farooq A. Chaudhry, Patricia Pellikka, Piotr Slomka, Andrew E. Arai, Ami E. Iskandrian, Timothy M. Bateman, Gary V. Heller & 9 others Todd D. Miller, Eike Nagel, Abhinav Goyal, Salvador Borges-Neto, William E. Boden, Harmony R. Reynolds, Judith S. Hochman, David J. Maron, Pamela S. Douglas

Research output: Contribution to journalReview article

92 Citations (Scopus)

Abstract

The lack of standardized reporting of the magnitude of ischemia on noninvasive imaging contributes to variability in translating the severity of ischemia across stress imaging modalities. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with ≥10% ischemic myocardium on stress nuclear imaging as the risk threshold for stress echocardiography and cardiac magnetic resonance. A narrative review revealed that ≥10% ischemic myocardium on stress nuclear imaging was associated with a median rate of CAD death or MI of 4.9%/year (interquartile range: 3.75% to 5.3%). For stress echocardiography, ≥3 newly dysfunctional segments portend a median rate of CAD death or MI of 4.5%/year (interquartile range: 3.8% to 5.9%). Although imprecisely delineated, moderate-severe ischemia on cardiac magnetic resonance may be indicated by ≥4 of 32 stress perfusion defects or ≥3 dobutamine-induced dysfunctional segments. Risk-based thresholds can define equivalent amounts of ischemia across the stress imaging modalities, which will help to translate a common understanding of patient risk on which to guide subsequent management decisions.

Original languageEnglish (US)
Pages (from-to)593-604
Number of pages12
JournalJACC: Cardiovascular Imaging
Volume7
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Stress Echocardiography
Magnetic Resonance Spectroscopy
Ischemia
Magnetic Resonance Imaging
Coronary Artery Disease
Myocardial Infarction
Myocardium
Dobutamine
Perfusion

Keywords

  • cardiac imaging
  • ischemia
  • prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Shaw, L. J., Berman, D. S., Picard, M. H., Friedrich, M. G., Kwong, R. Y., Stone, G. W., ... Douglas, P. S. (2014). Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging. JACC: Cardiovascular Imaging, 7(6), 593-604. https://doi.org/10.1016/j.jcmg.2013.10.021

Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging. / Shaw, Leslee J.; Berman, Daniel S.; Picard, Michael H.; Friedrich, Matthias G.; Kwong, Raymond Y.; Stone, Gregg W.; Senior, Roxy; Min, James K.; Hachamovitch, Rory; Scherrer-Crosbie, Marielle; Mieres, Jennifer H.; Marwick, Thomas H.; Phillips, Lawrence M.; Chaudhry, Farooq A.; Pellikka, Patricia; Slomka, Piotr; Arai, Andrew E.; Iskandrian, Ami E.; Bateman, Timothy M.; Heller, Gary V.; Miller, Todd D.; Nagel, Eike; Goyal, Abhinav; Borges-Neto, Salvador; Boden, William E.; Reynolds, Harmony R.; Hochman, Judith S.; Maron, David J.; Douglas, Pamela S.

In: JACC: Cardiovascular Imaging, Vol. 7, No. 6, 2014, p. 593-604.

Research output: Contribution to journalReview article

Shaw, LJ, Berman, DS, Picard, MH, Friedrich, MG, Kwong, RY, Stone, GW, Senior, R, Min, JK, Hachamovitch, R, Scherrer-Crosbie, M, Mieres, JH, Marwick, TH, Phillips, LM, Chaudhry, FA, Pellikka, P, Slomka, P, Arai, AE, Iskandrian, AE, Bateman, TM, Heller, GV, Miller, TD, Nagel, E, Goyal, A, Borges-Neto, S, Boden, WE, Reynolds, HR, Hochman, JS, Maron, DJ & Douglas, PS 2014, 'Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging', JACC: Cardiovascular Imaging, vol. 7, no. 6, pp. 593-604. https://doi.org/10.1016/j.jcmg.2013.10.021
Shaw, Leslee J. ; Berman, Daniel S. ; Picard, Michael H. ; Friedrich, Matthias G. ; Kwong, Raymond Y. ; Stone, Gregg W. ; Senior, Roxy ; Min, James K. ; Hachamovitch, Rory ; Scherrer-Crosbie, Marielle ; Mieres, Jennifer H. ; Marwick, Thomas H. ; Phillips, Lawrence M. ; Chaudhry, Farooq A. ; Pellikka, Patricia ; Slomka, Piotr ; Arai, Andrew E. ; Iskandrian, Ami E. ; Bateman, Timothy M. ; Heller, Gary V. ; Miller, Todd D. ; Nagel, Eike ; Goyal, Abhinav ; Borges-Neto, Salvador ; Boden, William E. ; Reynolds, Harmony R. ; Hochman, Judith S. ; Maron, David J. ; Douglas, Pamela S. / Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging. In: JACC: Cardiovascular Imaging. 2014 ; Vol. 7, No. 6. pp. 593-604.
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AU - Shaw, Leslee J.

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AU - Kwong, Raymond Y.

AU - Stone, Gregg W.

AU - Senior, Roxy

AU - Min, James K.

AU - Hachamovitch, Rory

AU - Scherrer-Crosbie, Marielle

AU - Mieres, Jennifer H.

AU - Marwick, Thomas H.

AU - Phillips, Lawrence M.

AU - Chaudhry, Farooq A.

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AU - Slomka, Piotr

AU - Arai, Andrew E.

AU - Iskandrian, Ami E.

AU - Bateman, Timothy M.

AU - Heller, Gary V.

AU - Miller, Todd D.

AU - Nagel, Eike

AU - Goyal, Abhinav

AU - Borges-Neto, Salvador

AU - Boden, William E.

AU - Reynolds, Harmony R.

AU - Hochman, Judith S.

AU - Maron, David J.

AU - Douglas, Pamela S.

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