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{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T18:04:51Z","timestamp":1694887491069},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n <jats:title>Objectives<\/jats:title>\n <jats:p>In patients of advanced age, the feasibility of myocardial ischemia testing might be limited by age-related comorbidities and falling compliance abilities. Therefore, we aimed to test the accuracy of 3D cardiac magnetic resonance (CMR) stress perfusion in the elderly population as compared to reference standard fractional flow reserve (FFR).<\/jats:p>\n <\/jats:sec><jats:sec>\n <jats:title>Methods<\/jats:title>\n <jats:p>Fifty-six patients at age 75 years or older (mean age 79 \u00b1 4 years, 35 male) underwent 3D CMR perfusion imaging and invasive coronary angiography with FFR in 5 centers using the same study protocol. The diagnostic accuracy of CMR was compared to a control group of 360 patients aged below 75 years (mean age 61 \u00b1 9 years, 262 male). The percentage of myocardial ischemic burden (MIB) relative to myocardial scar burden was further analyzed using semi-automated software.<\/jats:p>\n <\/jats:sec><jats:sec>\n <jats:title>Results<\/jats:title>\n <jats:p>Sensitivity, specificity, and positive and negative predictive values of 3D perfusion CMR deemed similar for both age groups in the detection of hemodynamically relevant (FFR < 0.8) stenosis (\u2265 75 years: 86%, 83%, 92%, and 75%; < 75 years: 87%, 80%, 82%, and 85%; <jats:italic>p<\/jats:italic> > 0.05 all). While MIB was larger in the elderly patients (15% \u00b1 17% vs. 9% \u00b1 13%), the diagnostic accuracy of 3D CMR perfusion was high in both elderly and non-elderly populations to predict pathological FFR (AUC: 0.906 and 0.866).<\/jats:p>\n <\/jats:sec><jats:sec>\n <jats:title>Conclusions<\/jats:title>\n <jats:p>3D CMR perfusion has excellent diagnostic accuracy for the detection of hemodynamically relevant coronary stenosis, independent of patient age.<\/jats:p>\n <\/jats:sec><jats:sec>\n <jats:title>Key Points<\/jats:title>\n <jats:p><jats:italic>\u2022 The increasing prevalence of coronary artery disease in elderly populations is accompanied with a larger ischemic burden of the myocardium as compared to younger individuals.<\/jats:italic><\/jats:p>\n <jats:p><jats:italic>\u2022 3D cardiac magnetic resonance perfusion imaging predicts pathological fractional flow reserve in elderly patients aged \u2265 75 years with high diagnostic accuracy.<\/jats:italic><\/jats:p>\n <jats:p><jats:italic>\u2022 Ischemia testing with 3D CMR perfusion imaging has similarly high accuracy in the elderly as in younger patients and it might be particularly useful when other non-invasive techniques are limited by aging-related comorbidities and falling compliance abilities.<\/jats:italic><\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00330-022-09040-7","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T05:02:54Z","timestamp":1660885374000},"page":"339-347","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic performance of 3D cardiac magnetic resonance perfusion in elderly patients for the detection of coronary artery disease as compared to fractional flow reserve"],"prefix":"10.1007","volume":"33","author":[{"given":"Mih\u00e1ly","family":"K\u00e1rolyi","sequence":"first","affiliation":[]},{"given":"Alexander","family":"Gotschy","sequence":"additional","affiliation":[]},{"given":"Malgorzata","family":"Polacin","sequence":"additional","affiliation":[]},{"given":"Sven","family":"Plein","sequence":"additional","affiliation":[]},{"given":"Ingo","family":"Paetsch","sequence":"additional","affiliation":[]},{"given":"Cosima","family":"Jahnke","sequence":"additional","affiliation":[]},{"given":"Michael","family":"Frick","sequence":"additional","affiliation":[]},{"given":"Rolf","family":"Gebker","sequence":"additional","affiliation":[]},{"given":"Hatem","family":"Alkadhi","sequence":"additional","affiliation":[]},{"given":"Sebastian","family":"Kozerke","sequence":"additional","affiliation":[]},{"ORCID":"http:\/\/orcid.org\/0000-0002-3383-4998","authenticated-orcid":false,"given":"Robert","family":"Manka","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"issue":"11","key":"9040_CR1","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1093\/ehjci\/jez054","volume":"20","author":"LE Juarez-Orozco","year":"2019","unstructured":"Juarez-Orozco LE, Saraste A, Capodanno D et al (2019) Impact of a decreasing pre-test probability on the performance of diagnostic tests for coronary artery disease. 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