Multicentre medicoeconomic evaluation of cardiac magnetic resonance imaging for predicting coronary artery disease in left ventricular dysfunction: The CAMAREC study design - 02/09/23
, Damien Mandry b, Gregory Ducrocq c, Isabelle Durand-Zaleski d, Toni Alfaiate e, Damien Millischer f, Olivier Milleron c, Olivier Huttin b, Mathieu Valla g, Loic Belle h, Yoan Lavie-Badie i, Bruno Farah j, Christelle Diakov k, Damien Logeart l, Benjamin Safar f, Charles Burdet e, m, Guillaume Jondeau c, nfor
the CAMAREC investigators
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Graphical abstract |
Highlights |
• | CAMAREC: a multicentre diagnostic study with 406 patients. |
• | Assesses cardiac MRI versus angiography in unexplained reduced LVEF. |
• | Evaluates medicoeconomic impact and diagnostic effects. |
• | Independent committees review MRI and angiography images. |
• | Results could influence cardiomyopathy guidelines. |
Abstract |
Background |
Cardiac magnetic resonance imaging may provide a non-invasive alternative to coronary angiography for differentiating between ischaemic and non-ischaemic cardiomyopathy in cases of unexplained reduced left ventricular ejection fraction.
Aim |
The CAMAREC study aims to evaluate the diagnostic accuracy of cardiac magnetic resonance imaging in predicting significant coronary artery disease in patients with reduced left ventricular ejection fraction, using coronary angiography as the gold standard for comparison.
Methods |
CAMAREC is a prospective cohort study of 406 patients in 10 centres with newly diagnosed, unexplained left ventricular ejection fraction ≤ 45%. Cardiac magnetic resonance imaging and coronary angiography will be conducted within a 2-week interval, starting with cardiac magnetic resonance imaging; independent committees will review the results blindly. Primary outcome is sensitivity of detecting ischaemic scar on cardiac magnetic resonance imaging for predicting significant coronary artery disease on coronary angiography according to Felker's criteria. Secondary outcomes include specificity and positive and negative predictive values (with 95% confidence intervals) of cardiac magnetic resonance imaging for predicting significant coronary artery disease in patients with reduced left ventricular ejection fraction, kappa concordance coefficient between cardiac magnetic resonance imaging and coronary angiography for diagnosing the affected myocardial territory, and the impact of cardiac magnetic resonance imaging on revascularization decisions. Two ancillary studies will evaluate the incremental cost-effectiveness of using cardiac magnetic resonance imaging first versus coronary angiography first, and the sensitivity of pre- and postcontrast T1-mapping for predicting significant coronary artery disease in patients with reduced left ventricular ejection fraction.
Conclusion |
Our study protocol is designed to rigorously evaluate cardiac magnetic resonance imaging as a non-invasive alternative to coronary angiography in patients with unexplained reduced left ventricular ejection fraction. The results will have significant implications for patient management, and may support growing evidence for the clinical utility of cardiac magnetic resonance imaging.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiac magnetic resonance imaging, Coronary angiography, Ischaemic cardiomyopathy, Non-ischaemic cardiomyopathy, Left ventricular ejection fraction
Abbreviations : CA, CAD, CMR, LAD, LGE, LVEF, MINOCA
Plan
| ☆ | Tweet: Exciting new research ahead! The CAMAREC study investigates cardiac MRI's ability to predict coronary artery disease in patients with reduced left ventricular ejection fraction. This could revolutionize patient management!. |
Vol 116 - N° 8-9
P. 366-372 - août 2023 Retour au numéro
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