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MRI Perfusion Equals FFR for Coronary Disease Evaluation

By MedImaging International staff writers
Posted on 03 Jul 2019

A new study shows that non-invasive magnetic resonance imaging (MRI) measurement of cardiac blood flow is on par with cardiac catheterization.

Researchers at Goethe University Hospital (KGU; Frankfurt am Main, Germany), National University of Singapore (NUS, Singapore), the University of Leeds (United Kingdom), and other institutions conducted a multicenter, clinical-effectiveness trial to examine if a cardiovascular MRI–based strategy is non-inferior to an fractional flow reserve (FFR) cardiac catheterization angiography based strategy, with respect to major adverse cardiac events. The study included 918 patients with typical angina to a cardiovascular MRI–based strategy or an FFR-based strategy.

Revascularization was recommended for patients in the cardiovascular-MRI group with ischemia in at least 6% of the myocardium, or in the FFR group with an FFR of 0.8 or less. The composite primary outcome was death, nonfatal myocardial infarction (MI), or target-vessel revascularization within one year. The results revealed that in the MRI group, only 36% required a diagnostic cardiac catheterization and vascular dilation, compared to the FFR group (45 %). Importantly, the two groups did not differ in terms of continuing symptoms, the development of new symptoms, complications, or death. The study was published on June 20, 2019, in the New England Journal of Medicine (NEJM).

“Patients with stable chest pains who previously would have received cardiac catheterization can alternatively be examined with MRI,” concluded lead author Professor Eike Nagel, MD, of KGU. “The results for the patients are just as good, but an examination by MRI has many advantages: the procedure takes about 40 minutes, patients merely receive a small cannula in their arm, and are not subject to radiation.”

FFR is a physiological index used to determine the hemodynamic severity of atherosclerotic narrowing of the coronary arteries. It specifically identifies which coronary narrowing is responsible for the ischemic obstruction of the flow of blood to a patient’s heart muscle, and helps guide interventional cardiologists in determining which lesions warrant stenting, resulting in improved patient outcomes and reduced health care costs.

Related Links:
Goethe University Hospital
National University of Singapore
University of Leeds

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70 (!!!!! 1605.9875488281): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778510 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (267.02880859375): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778510 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (49.114227294922): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (46.014785766602): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778510 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (33.855438232422): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778510 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (30.994415283203): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (69.856643676758): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (26.226043701172): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3939.8670196533): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

105 (140.90538024902): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

106 (68.902969360352): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778510 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778510 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

109 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

110 (81.777572631836): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294778510 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (734.80606079102): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294778510 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (691.89071655273): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (478.02925109863): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (107.0499420166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

115 (146.15058898926): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

116 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

117 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

118 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

119 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

120 (378.13186645508): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 50785.064697266): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (259.1609954834): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

123 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

124 (509.02366638184): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778510 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778510 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 690163.13552856): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (361.91940307617): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (51.021575927734): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (41.007995605469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (254.15420532227): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (504.0168762207): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (!!!!! 3796.1006164551): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (!!!!! 1033.0677032471): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (739.81285095215): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (!!!!! 1139.8792266846): SELECT name FROM jos_deeppockets WHERE id=212

136 (50.067901611328): SELECT name FROM jos_deeppockets WHERE id=212

137 (676.87034606934): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (549.0779876709): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (683.06922912598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

140 (499.96376037598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

141 (!!!!! 13343.095779419): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 1321.0773468018): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778510 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (133.03756713867): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778510 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 6494.9989318848): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (176.90658569336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (100.85105895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

147 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

148 (!!!!! 1602.8881072998): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (119.92454528809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

150 (90.837478637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

151 (85.115432739258): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778510 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778510 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (59.127807617188): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

153 (36.954879760742): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

154 (38.14697265625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (136.13700866699): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

156 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778510 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778510 AND published='1' LIMIT 1

157 (63.896179199219): select jos_twitters.link from jos_twitters where cat=10

158 (36.954879760742): select jos_facebook.link from jos_facebook where cat=10

159 (36.954879760742): select jos_google_plus.link from jos_google_plus where cat=10

160 (35.04753112793): select jos_linkedin.link from jos_linkedin where cat=10

161 (380.03921508789): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 2099.0371704102): insert into jos_banners_delta values (14615,'2025-05-02 09:52:53','3.12.107.192','view'),(14202,'2025-05-02 09:52:53','3.12.107.192','view'),(14203,'2025-05-02 09:52:53','3.12.107.192','view')

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