A Novel Ferumoxytol-enhanced Cardiac Magnetic Resonance for the Detection of Calcified Coronary Arteries

• Superparamagnetic Iron Oxide Nanoparticles (Drug), also known as Ferumoxytol: Patients will receive a novel ferumoxytol-enhanced cardiac magnetic resonance imaging.

Primary outcomes

• Degree of vascular stenosis at the site of coronary calcification. [baseline]: Degree of vascular stenosis at the site of coronary calcification(measured by CAG, CCTA, Fe-CMRA): 0-100%.

Secondary outcomes

• CT-FFR, Agatston score, and the angle of calcification lesions occupying vascular lumen [baseline]: ①CT-FFR: computed tomography fractional flow reserve. ②Agatston score:0 point: No calcification; 1 to 10 points: Minimal plaque burden; 11 to 100 points: Mild plaque burden; 101 to 400 points: Moderate plaque burden; Greater than 400 points: Extensive plaque burden. ③the angle of calcification lesions occupying vascular lumen (CCTA)：0°-360°
• calcium score of the plaque measured by OCT [baseline]: OCT: calcium score of the plaque (①Calcification angle: the angle of the calcified plaque surrounding the vessel wall, a larger angle indicates more severe calcification. ②Calcification length: the longitudinal extension length of the calcified plaque along the vessel. ③Calcification thickness: the maximum thickness of the calcified plaque).
• Fe-CMRA image quality score [baseline]: Fe-CMRA image quality score: the image quality was assessed by a 4-point scale: 1=poor (coronary vessel barely evident or noisy image); 2=moderate (coronary vessel visible but diagnostic confidence low); 3=good (coronary artery adequately visualized and diagnostic quality image); and 4=excellent (coronary artery clearly depicted).

Sex: All, ages: 18 Years to 75 Years

Inclusion Criteria:

1. Age ≥18 years, <75 years;
2. Imaging specialists evaluate CCTA images taken within 30 days and report that calcification occupied one or more of the patient's vascular lumen at an angle of >50% (using the coronary artery segmentation method recommended by the American Heart Association, including nine segments of the major branches of the coronary artery);
3. Patient who will undergo coronary angiography;
4. Patient with normal renal function or chronic renal insufficiency (CKD) stage 1-3;
5. Patient who signs the informed consent.

Exclusion Criteria:

1. People who are allergic to iodine contrast media or have a history of allergy to iron or dextran or are allergic themselves;
2. Because of psychological (such as suffering from claustrophobic syndrome) or physical reasons (such as the presence of metal objects in the body) can not receive MRI examination;
3. suffering from terminal diseases (such as malignant tumors) or life expectancy < 1 year;
4. Pregnant or lactating women;
5. People with limited hearing;
6. Patients with grade III-IV heart function;
7. Patients with a history of coronary artery stent implantation or coronary artery bypass;
8. Other iron agents are being used orally or intravenously;
9. Patients with hemosiderosis or hemochromatosis;
10. Patients with acute coronary syndrome;
11. Patients with hyperthyroidism;
12. Any other candidates deemed unsuitable by the researchers.

• Chunjian Li, Phd、MD, Principal investigator, The First Affiliated Hospital with Nanjing Medical University