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Cardiovascular magnetic resonance stress perfusion testing is of great utility in the detection of coronary artery disease in women, US and German researchers report.

US and German researchers report in the July issue of JACC: Cardiovascular Imaging.

As lead investigator Dr. Igor Klem told Reuters Health, "We have shown that CMR stress testing not only provides a clinically useful tool to evaluate women with chest pain, but provides very comprehensive information on the status of the heart."

Dr. Klem of Duke University Medical Center, Durham, North Carolina and colleagues studied 147 women with chest pain or other symptoms suggestive of CAD.

The CMR test consisted of "cine rest function, adenosine-stress and rest perfusion, and delayed-enhancement CMR infarction imaging."

CMR was completed in 136 women, and 37 (27 per cent) had CAD on coronary angiography. For the diagnosis of CAD, using stenoses of 70 per cent or greater as a cut-off point, the CMR stress test had a sensitivity of 84 per cent, a specificity of 88 per cent and an accuracy of 87 per cent.

When the stenosis cut-off point was reduced to 50 per cent, the accuracy fell to 82 per cent.

Sensitivity was lower in women with single-vessel disease (71 per cent) compared to those with multivessel disease (100 per cent) and for those with left ventricular mass of 97 g or less (69 per cent versus 95 per cent).

"With this test we can identify areas of the myocardium that are inadequately supplied with blood due to coronary artery disease, we can see damaged tissue due to myocardial infarction with an unprecedented accuracy, and the consequences on heart function," continued Dr. Klem.

"We have performed this test at Duke since 2002," he concluded, "and several institutions in the US and Europe have since adopted the procedure."

JACC: Cardiovascular Imaging 2008;1:436-445