Comparing MRI and cardiac catheterization.

<p>Comparing MRI and cardiac catheterization.</p

Weighted Kappa ranges.

<p>Weighted Kappa ranges.</p

Baseline characteristics.

<p>CAD, coronary artery disease; MI, myocardial infarction; PCI, percutaneous coronary angiography; CABG, coronary artery bypass grafting; ESRD, end stage renal disease; NYHA, new york heart association; CVA, cerebrovascular accident; LVEDD, left ventricular end-diastolic diameter; LVESD, left ventricular end-systolic diameter.</p

Measurement of visual assessment parameters.

<p>Measurement of visual assessment parameters.</p

Comparing MRI and echocardiography.

<p>Comparing MRI and echocardiography.</p

Comparing cardiac catheterization and echocardiography.

<p>Comparing cardiac catheterization and echocardiography.</p

Visual assessment parameters for determining mitral regurgitation severity.

<p>1. Grossman W, Dexter L. Profiles in valvular heart disease. In: Grossman W, ed. <i>Cardiac Catheterization and Angiography</i>. 2nd ed. Philadelphia, Pa: Lea & Febiger; 1980: 305–324.</p><p>2. Zoghbi WA, Enriquez-Sarano M, Foster E, et al. <i>Recommendations for evaluation of the severity of native valvular regurgitation with two dimensional and Doppler echocardiography</i>. J Am Soc Echocardiogr. 2003;16: 777–802.</p><p>LA: Left Atrial.</p><p>LVESD  =  Left Ventricular End-Systolic Diameter.</p

Examples of mild, moderate, and severe mitral regurgitation for each imaging modality.

<p>Examples of mild, moderate, and severe mitral regurgitation for each imaging modality.</p

ROC analysis.

<p>ROC analysis.</p

The Systematic Evaluation of Identifying the Infarct Related Artery Utilizing Cardiac Magnetic Resonance in Patients Presenting with ST-Elevation Myocardial Infarction

<div><p>Background</p><p>Identification of the infarct-related artery (IRA) in patients with STEMI using coronary angiography (CA) is often based on the ECG and can be challenging in patients with severe multi-vessel disease. The current study aimed to determine how often percutaneous intervention (PCI) is performed in a coronary artery different from the artery supplying the territory of acute infarction on cardiac magnetic resonance imaging (CMR).</p><p>Methods</p><p>We evaluated 113 patients from the Reduction of infarct Expansion and Ventricular remodeling with Erythropoetin After Large myocardial infarction (REVEAL) trial, who underwent CMR within 4±2 days of revascularization. Blinded reviewers interpreted CA to determine the IRA and CMR to determine the location of infarction on a 17-segment model. In patients with multiple infarcts on CMR, acuity was determined with T2-weighted imaging and/or evidence of microvascular obstruction.</p><p>Results</p><p>A total of 5 (4%) patients were found to have a mismatch between the IRA identified on CMR and CA. In 4/5 cases, there were multiple infarcts noted on CMR. Thirteen patients (11.5%) had multiple infarcts in separate territories on CMR with 4 patients (3.5%) having multiple acute infarcts and 9 patients (8%) having both acute and chronic infarcts.</p><p>Conclusions</p><p>In this select population of patients, the identification of the IRA by CA was incorrect in 4% of patients presenting with STEMI. Four patients with a mismatch had an acute infarction in more than one coronary artery territory on CMR. The role of CMR in patients presenting with STEMI with multi-vessel disease on CA deserves further investigation.</p></div