Advanced Cardiac Magnetic Resonance Imaging for Assessment of Obstructive Coronary Artery Disease: ADVOCATE-CMR

Diagnostic accuracy of QP CMR (stress myocardial blood flow [MBF], stress relative MBF [rMBF], myocardial perfusion reserve [MPR] and relative MPR [rMPR]) to detect obstructive CAD, as defined by FFR

Stress perfusion cardiovascular magnetic resonance (CMR) imaging is an established
 non-invasive imaging test for detection of obstructive coronary artery disease (CAD). Fully
 automated quantitative perfusion CMR (QP CMR) is a new technical advancement, which offers
 measurement of myocardial blood flow in CMR. Additionally, recent innovations have introduced
 various contrast-agent-free methods for CAD assessment, such as stress T1 mapping reactivity
 (∆T1) and oxygen-sensitive CMR (OS CMR). These methods might eliminate the necessity for
 contrast administration in clinical practice, simplifying, reducing time, invasiveness and
 costs in evaluating patients with suspected obstructive CAD. The ADVOCATE-CMR study aims to
 validate QP CMR, ∆T1 and OS CMR imaging against invasive fractional flow reserve (FFR) for
 detection of obstructive CAD. The study also aims to head-to-head compare the diagnostic
 accuracy of these CMR techniques with the conventional visual assessment of stress perfusion
 CMR and to correlate them to short- and long-term clinical outcomes.