Is subendocardial ischaemia present in patients with chest pain and normal coronary angiograms? A cardiovascular MR study.

I read with interest the recent article by Vermeltfoort et al. , 1 on the use of dynamic contrast enhancement in MRI to evaluate the possible presence of subendocardial ischaemia in patients with chest pain and normal coronary arteries (‘syndrome X’). Their conclusion, that they found no evidence of subendocardial hypoperfusion with adenosine stress in these patients, is in striking contrast to a previous report by Panting et al. , 2 who found evidence of a failure of the perfusion of the …