Coronary disease & ACSSecondary analysis
Association of left ventricular mass with discordant stress cardiac magnetic resonance and coronary angiography
- substudy of the Dan-NICAD 2 trial
Authors' conclusion
In patients with suspected obstructive CAD, increased LVM can potentially confound concordance between stress CMR and ICA. This is due to increased microvascular resistance, which decreases the pressure gradient across an epicardial stenosis, resulting in a false high FFR and thus, normal ICA.
Study context
- Population
- Patients with suspected obstructive coronary artery disease (CAD) on coronary computed tomography angiography (CCTA), examined with both rest and stress cardiac magnetic resonance (CMR) and ICA for invasive physiological measurementspatients with suspected obstructive CAD on CCTA
- Participants
- 354 patients
- Comparison
- Within four binary groups based on normal/abnormal stress CMR and ICA
Primary result
LVM (sex-adjusted, per cent)
Median difference
8.0%
P < 0.001
As reported in the abstract
Further findings
| Outcome | discordant abnormal stress CMR and normal ICA | concordant normal stress CMR and ICA |
|---|---|---|
| Median LVM and index of microvascular resistance | ||
| LVM | 124% | 111% |
| index of microvascular resistance | 29 | 19 |
- Median left ventricular mass (LVM) and index of microvascular resistance: LVM P = 0.001
- Median LVM and index of microvascular resistance: index of microvascular resistance P = 0.072
LVM, with or without haemodynamically obstructive CAD
- Similar LVM in patients with or without haemodynamically obstructive CAD (median difference = 2%)
- P = 0.222
Original publication
Association of left ventricular mass with discordant stress cardiac magnetic resonance and coronary angiography. Eur Heart J Cardiovasc Imaging. Published 10 February 2026. doi:10.1093/ehjci/jeaf350
Summarised from the published abstract; every number is checked against it