Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiology

Background: The purpose of this study was to assess the diagnostic and prognostic value of vasodilator stress CMR in patients with known or suspected coronary artery disease CAD having atrial fibrillation. Methods: 122 consecutive patients with atrial fibrillation referred for vasodilator stress CMR (adenosine/regadenosone) were enrolled. Patients in the positive and negative stress groupswere followed up for cardiac death, nonfatal myocardial infarction, re-hospitalization for unstable angina and obstructive CAD needing coronary revascularization. Results: From a total of 33 patients in the positive stress group who completed follow up, only 26 patients underwent coronary angiography. From the 26 patients, percutaneous coronary intervention (PCI) was done in only 19 patients. From a total of 96 patients in the negative stress group who completed follow up five patients needed PCI during first year of follow up. Vasodilator stress CMR in Af patients had a sensitivity of 78% and a specificity of 92%, positive predictive value of 70% and a negative predictive value of 95%.During mean follow up of 21±17 months 4 deaths occurred in the two groups only one of them being in the negative stress group p<0.021. No myocardial infarction occurred in both groups. Conclusion: Vasodilator stress CMR in AF patients has a good diagnostic performance and patients with a negative vasodilator stress CMR scan hasan excellent prognosis with a 95% event-free survival at one-year follow-up

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