The Non-Invasive Diagnosis of Chronic Coronary Syndrome: A Focus on Stress Computed Tomography Perfusion and Stress Cardiac Magnetic Resonance

Léon Groenhoff, Giulia De Zan, Pietro Costantini, Agnese Siani, Eleonora Ostillio, Serena Carriero, Giuseppe Muscogiuri, Luca Bergamaschi, Giuseppe Patti, Carmine Pizzi, Sandro Sironi, Anna Giulia Pavon, Alessandro Carriero, Marco Guglielmo*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Coronary artery disease is still a major cause of death and morbidity worldwide. In the setting of chronic coronary disease, demonstration of inducible ischemia is mandatory to address treatment. Consequently, scientific and technological efforts were made in response to the request for non-invasive diagnostic tools with better sensitivity and specificity. To date, clinicians have at their disposal a wide range of stress-imaging techniques. Among others, stress cardiac magnetic resonance (S-CMR) and computed tomography perfusion (CTP) techniques both demonstrated their diagnostic efficacy and prognostic value in clinical trials when compared to other non-invasive ischemia-assessing techniques and invasive fractional flow reserve measurement techniques. Standardized protocols for both S-CMR and CTP usually imply the administration of vasodilator agents to induce hyperemia and contrast agents to depict perfusion defects. However, both methods have their own limitations, meaning that optimizing their performance still requires a patient-tailored approach. This review focuses on the characteristics, drawbacks, and future perspectives of these two techniques.

Original languageEnglish
Article number3793
JournalJournal of Clinical medicine
Volume12
Issue number11
DOIs
Publication statusPublished - Jun 2023

Keywords

  • cardiac computed tomography perfusion
  • cardiac coronary syndrome
  • coronary artery disease
  • stress imaging
  • stress magnetic cardiac resonance

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