Thomas W. Schlosser MD, Presenter: Nothing to Disclose

Kai Nassenstein, Abstract Co-Author: Nothing to Disclose

Peter Hunold MD, Abstract Co-Author: Speaker, Bayer AG

Susanne Moebus, Abstract Co-Author: Nothing to Disclose

Ulla Roggenbuck, Abstract Co-Author: Nothing to Disclose

Nils Lehmann, Abstract Co-Author: Nothing to Disclose

Karl-Heinz Jockel, Abstract Co-Author: Nothing to Disclose

Joerg Barkhausen MD, Abstract Co-Author: Nothing to Disclose

Raimund Erbel, Abstract Co-Author: Nothing to Disclose

Burkhard Sievers, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to evaluate the prevalence of pathological cardiac MRI findings in subjects with mild coronary calcifications.

101 asymptomatic volunteers were selected from a large population-based screening study (Heinz Nixdorf Recall study) in accordance to their Agatston calcium score (group 1: Agatston score: 0, n = 51, age 60.10 +- 6.41; group 2: Agatston score: 1 – 100, n = 50, age 63.9 +- 6.33). All subjects underwent cardiac MRI at 1.5 T (Magnetom Avanto, Siemens, Erlangen, Germany). The MRI protocol included a) steady-state free precession cine sequences for functional assessment of the left ventricle, b) saturation-recovery perfusion sequences for the assessment of adenosine stress-/rest perfusion and c) inversion-recovery spoiled gradient echo sequences 15 min after contrast administration for the quantification of late gadolinium enhancement (LGE). Analysis was performed by consensus of 3 experienced readers using the 17-segment model proposed by the AHA and a standard visual scoring system for myocardial function, perfusion and viability assessment.

Overall, a stress-induced perfusion deficit was present in 1/101 subjects (1.0 %), whereas late gadolinium enhancement was seen in 17/101 subjects (16.8%). Group 1 (Agatston score: 0): In this group none of the subjects showed a perfusion deficit, whereas in seven subjects late gadolinium enhancement was observed (13.7%). Two of the seven subjects showed an ischemic-type pattern of late gadolinium enhancement (3.9%) indicating chronic infarction. Group 2: Median Agatston score of group 2 was 19 (Q1, 11; Q3, 43). In this group a perfusion deficit could be observed in one subject (2%) whereas late gadolinium enhancement was observed in ten subjects (20%). However, all of these late gadolinium enhancement patterns were assessed as non-ischemic.

The prevalence of stress-induced myocardial ischemia in subjects with mild coronary calcifications score is low, whereas the frequency of non-ischemic late gadolinium enhancement is relatively high. Long term follow up will clarify whether these cardiac MRI findings contribute to cardiovascular risk stratification in asymptomatic subjects.

Long term follow up will clarify whether cardiac MRI contribute to cardiovascular risk stratification in subjects with mild coronary calcifications.

Schlosser, T, Nassenstein, K, Hunold, P, Moebus, S, Roggenbuck, U, Lehmann, N, Jockel, K, Barkhausen, J, Erbel, R, Sievers, B, Myocardial Perfusion Defects and Late Gadolinium Enhancement in Asymptomatic Subjects with Subclinical Atherosclerosis and Mild Coronary Calcifications: Results of the Heinz Nixdorf Recall MRI Substudy.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043418.html