Does stress perfusion imaging improve the diagnostic accuracy of late gadolinium enhanced cardiac magnetic resonance for establishing the etiology of heart failure?

Table 3 Summary of angiographic and CMR findings in patients with angiographically-determined significant CAD and a diagnosis of NICM on CMR

Angiogram findings	Non-stress CMR findings	Perfusion-CMR findings	Comments
Moderate (50% stenosis) LCx disease.	Global LV hypokinesis. Severe bi-atrial dilatation with MR and TR. Mid-wall LGE present.	No perfusion abnormality detected.	CAD likely coincident and not main etiological factor.
Mild left mainstem (~30%) and severe RCA disease.	Global LVSD and marked intraventricular dyssynchrony. Severely dilated LA. Moderate MR. No LGE.	No perfusion abnormality detected.	CAD likely coincident and not main etiological factor. Patient condition improved with intensive medical therapy (now NYHA class I).
Three-vessel coronary disease. Severe LAD and LCx disease, moderate RCA disease.	Severe hypokinesis starting in the midanterior segment, becoming akinetic in the apex. No valve disease. No LGE.	No perfusion abnormality detected.	True false-negative CMR. Patient underwent CABG.

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