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Whole-body MR vascular screening detects unsuspected concomitant vascular disease in coronary heart disease patients
Authors:Susanne C Ladd  Joerg F Debatin  Andreas Stang  Katja Bromen  Susanne Moebus  Michael Nuefer  Elke Gizewski  Isabel Wanke  Arnd Doerfler  Mark E Ladd  Jens Benemann  Raimund Erbel  Michael Forsting  Axel Schmermund  Karl-Heinz Jöckel
Institution:(1) Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany;(2) University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;(3) Medical Faculty, Institute of Medical Epidemiology, Biometry and Informatics, Martin-Luther University, 06112 Halle-Wittenberg, Germany;(4) European Commission, DG INFSO, 1049 Brussels, Belgium;(5) Institute of Medical Informatics, Biometry and Epidemiology, University Hospital, 45122 Essen, Germany;(6) Department of Neuroradiology, University of Erlangen Medical School, 91054 Erlangen, Germany;(7) Department of Neurology, University Hospital, 45122 Essen, Germany;(8) Department of Cardiology, University Hospital, 45122 Essen, Germany
Abstract:Coronary heart disease (CHD) patients often show atherosclerotic vascular disease in other vascular territories. We evaluated how often whole-body MR imaging detects concomitant arterial pathologies in CHD patients, and how often these pathologies were not known to the patients previously. Of 4,814 participants in the population-based Heinz Nixdorf Recall Study, 327 reported CHD (i.e., previous coronary bypass surgery, angioplasty); of those, 160 patients (mean age 66.4 years) were examined using MR of the brain, the heart (excluding the coronary arteries), and whole-body MR angiography. The prevalence of each vascular pathology was assessed, correlated to the others and compared to patients’ histories. Of the 160 CHD patients, 16 (10%) showed MR signs of stroke, and 77 (48.1%) had a stenosis >50% in at least one extracerebral peripheral artery (other than the coronaries), including 28 (17.5%) with relevant renal artery stenoses, and 20 (12.5%) with relevant extracerebral internal carotid artery stenoses. False negative histories were reported in 12 of 81 cases with myocardial infarctions, and in 11 of 16 cases with cerebrovascular infarctions. This whole-body atherosclerosis MR screening program allows previously unknown concomitant vascular disease to be detected in coronary heart disease patients. Its prospective value should be assessed in further studies.
Keywords:MR angiography  Coronary heart disease  Screening  Peripheral vascular disease  Cerebrovascular disease
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