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1%, and 36.7%, respectively. Figure 4 shows an example of the calculation of ischemia calculation. Pearson's correlation coefficient showed a strong correlation (r = 0.82; 95% CI: 0.70 to 0.89) between the DJS and ischemic volume on CMR (p TGF-beta inhibitor predicts the presence of hemodynamically significant coronary artery stenosis as measured by using FFR. In addition, it demonstrated close agreement between estimates of ischemic volume from 3D whole heart myocardial perfusion CMR and an invasive index of ischemic burden. 3D acquisition methods overcome some of the remaining limitations Ruxolitinib of myocardial perfusion CMR; specifically, the limited myocardial coverage offered by conventionally used 2D methods. Furthermore, 3D acquisition is more signal-to-noise efficient than 2D imaging; in addition, because all data are acquired in one shot, all images are acquired in the same cardiac phase. 3D myocardial perfusion CMR has become feasible as a result of recent advances in data acquisition speed, with several different methods proposed (4, 15?and?16). Following initial feasibility studies, a recent larger clinical study reported a sensitivity of 91.7% and a specificity of 74.3% of 3D myocardial perfusion CMR for the detection of coronary stenosis on QCA on a patient basis (5). However, QCA correlates poorly with the hemodynamic effect of a coronary stenosis because of effects of lesion proximity and length, calcification, collateral vessels, and dynamic changes in vasomotor tone (8). Pressure wire�Cderived FFR, which was the endpoint in the current study, is considered Megestrol Acetate the reference standard for assessing the hemodynamic significance of atherosclerotic coronary lesions and is a more appropriate comparator for ischemia imaging than QCA. Determining the functional significance of coronary stenosis is directly related to patient outcome, as shown for invasive assessment in the FAME and DEFER (9?and?17) cohorts and for noninvasive imaging in COURAGE and other studies (18, 19?and?20). Furthermore, a substudy of FAME suggested visual and functional disparity, which highlights the need for functional assessment in patients with CAD (21). For these reasons, current guidelines recommend the use of functional testing before elective revascularization (22). In clinical routine, however, fewer than one-half of patients are evaluated noninvasively before revascularization (23).