Kai Nassenstein, Presenter: Nothing to Disclose

Thomas W. Schlosser MD, Abstract Co-Author: Nothing to Disclose

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

Ulla Roggenbuck, Abstract Co-Author: Nothing to Disclose

Nils Lehmann, Abstract Co-Author: Nothing to Disclose

Raimund Erbel, Abstract Co-Author: Nothing to Disclose

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

Burkhard Sievers, Abstract Co-Author: Nothing to Disclose

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

To assess the prevalence and pattern of myocardial late gadolinium enhancement (LGE) in dependency on the Agatston coronary artery calcium (CAC) score in an asymptomatic screening population.

250 asymptomatic subjects (mean age 64±7 years) were selected from a large population-based screening study in accordance to their Agatston score (group 1: score 0, group 2: score 1-100, group 3: score 101-400, group 4: score 401-1000, group 5: score > 1000). LGE was assessed at 1.5 T. Images were evaluated by two experienced blinded observers in consensus, and in case of LGE its pattern was classified as ischemic or non-ischemic. The prevalence of ischemic and non-ischemic LGE was calculated for each CAC group. Numbering predefined CAC categories serially, we used logistic regression to calculate odds ratios (OR) with 95% confidence intervals (95%CI) for presence of LGE with increase by one CAC category. Results were adjusted for sex and age. Subjects were followed up for a median time of 1.5 years.

An ischemic pattern of LGE was observed in 6% (group 1: 4%, group 2: 0%, group 3: 2%, group 4: 8%, group 5: 16%), and an non-ischemic pattern in 12% (group 1: 10%, group 2: 20%, group 3: 4%, group 4: 13%, group 5: 13%) of the subjects. Statistical analysis showed a positive association between ischemic LGE and the Agatston score (OR 1.71, 95%CI 1.01-2.89, p=0.048), but no association between non-ischemic LGE and the Agatston score (OR 0.84, 95%CI 0.61-1.16, p=0.29). 3 subjects had a major adverse cardiac event (MACE; all non-lethal myocardial infarction) during follow up. All these subjects showed a non-ischemic LGE. Among those, one had only mild coronary calcifications (Agatston score 81), the other two showed distinct coronary calcifications (Agatston scores 489 and 1474, respectively).

A relatively high prevalence of LGE (especially of non-ischemic LGE) can be found in asymptomatic subjects independently from their coronary calcium score. Since we observed MACE in particular in subjects with LGE, cardiac MRI seems to be meaningful for risk stratification of asymptomatic patients.

The assessment of structural myocardial damages by means of cardiac MRI is meaningful in risk stratification of asymptomatic patients independent from their Agatston coronary calcium score.

Nassenstein, K, Schlosser, T, Hunold, P, Roggenbuck, U, Lehmann, N, Erbel, R, Jockel, K, Sievers, B, Barkhausen, J, Cardiac MRI: Prevalence of Late Gadolinium Enhancement in Dependency on the Agatston Coronary Artery Calcium Score.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005752.html