Myocardial blood flow is the dominant factor influencing cardiac magnetic resonance adenosine stress T2

2021 ◽  
Author(s):  
Jill J. Weyers ◽  
Venkat Ramanan ◽  
Ahsan Javed ◽  
Jennifer Barry ◽  
Melissa Larsen ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Myocardial Blood Flow ◽  
Adenosine Stress ◽  
Dominant Factor

scholarly journals Accuracy of Cardiac Magnetic Resonance of Absolute Myocardial Blood Flow With a High-Field System

2009 ◽  
Vol 2 (9) ◽  
pp. 1103-1110 ◽  
Author(s):  
Timothy F. Christian ◽  
Stephen P. Bell ◽  
Lawrence Whitesell ◽  
Michael Jerosch-Herold
Keyword(s):  
Blood Flow ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Myocardial Blood Flow ◽  
High Field ◽  
Absolute Myocardial Blood Flow ◽  
Field System

scholarly journals Dynamic SPECT with assessment myocardial blood flow and coronary flow reserve in MINOCA patients: comparison with cardiac magnetic resonance

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Mochula ◽  
OV Mochula ◽  
AN Maltseva ◽  
DA Vorobyeva ◽  
VV Ryabov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Cardiac Magnetic Resonance ◽  
Coronary Artery ◽  
Magnetic Resonance ◽  
Myocardial Perfusion ◽  
Myocardial Blood Flow ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Flow Reserve

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): grant of the President of the Russian Federation Background. In recent years a group of patients with acute myocardial infarction without obstructive coronary artery disease (MINOCA) is of interest. In this group of patients, there is a lack of information related to myocardial perfusion, blood flow and reserve, which could be important in term of risk and prognosis assessment. Purpose. To assess the global and regional myocardial blood flow and coronary flow reserve impairment in MINOCA patients compared to cardiac magnetic resonance (CMR). Methods. The study group comprised 28 patients (18 male, mean 62.9 ± 10.7years) with acute coronary syndrome. Based on ICA results all patients were divided into two groups: 1) MINOCA (n = 11); 2) patients with myocardial infarction with obstructive CAD (MICAD) (n = 17). A total of 12/17 (71%) MICAD patients underwent PCI with stenting; in 2/12 cases two arteries were revascularized. Within 7-10 days after admission to the hospital all patients underwent SPECT myocardial perfusion scintigraphy (MPS) with the assessment of standard indices (SSS, SRS, SDS) and quantitative parameters: rest MBF (rMBF), stress MBF (sMBF) and CFR (on CZT gamma-camera). Also, all patients underwent CMR with evaluation of infarct size (IF), microvascular obstruction (MVO), size of myocardial edema (ME) and transmural extent of myocardial infarction (TE). Results Visual analysis showed that SSS differed significantly (p = 0.001) among MINOCA and MICAD groups: 5 (3;6) vs 10 (5;13), respectively. According to the quantitative MPS data analysis, global sMBF and CFR values were significantly higher in MINOCA than in MICAD patients group: 1.2 (0.82;1.69) ml/min/g vs 0.62 (0.52;0.9) ml/min/g; 1.96 (1.23;2.42) vs 1.16 (0.98;1.64) , respectively. CMR indices such as IS, ME and TE were significantly lower in MINOCA compared to MICAD patients: 1.6 (0;7.8) vs 14.8 (6.3;22.6)%; 8(0;14) vs 18.5 (10;23)%; 0 (0;5) vs 18 (10;25), respectively. Seven(40%) MICAD group patients showed MVO, whereas there were no such patients in MINIOCA group. The regional analysis revealed that sMBF and CFR were significantly lower in LV regions characterized by myocardial injury compared to non-injured regions (based on CMR data): 0.78 (0.51;0.94) ml/min/g vs 1.11 (0.82;1.4) and 1.22 (0.91;1.74) vs 1.52 (1.14;2.42), respectively. Also, we found out significant correlation between regional quantitative SPECT indices and transmural extent of myocardial infarction evaluated by CMR: r=–0.4 for sMBF; r=–0.35 for CFR (p < 0.05). Conclusion. The analysis of quantitative MPS SPECT parameters showed that such approach allows identifying MBF and CFR disturbances both on global and regional level. These results showed that MINOCA patients characterized by mild reduction of myocardial blood flow and perfusion assessed visually and quantitatively. It means that despite the absence of obstructive coronary artery lesion this group of patients has more pronounced risk of cardiac events and need more aggressive observation and treatment.

Abnormal myocardial blood flow in children with mild/moderate aortic stenosis

2015 ◽  
Vol 25 (7) ◽  
pp. 1358-1366 ◽  
Author(s):  
Erin Madriago ◽  
Ronald Wells ◽  
David J. Sahn ◽  
Brian S. Diggs ◽  
Stephen M. Langley ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Aortic Stenosis ◽  
Myocardial Blood Flow ◽  
Left Ventricular ◽  
Infants And Children ◽  
Adenosine Infusion ◽  
Absolute Increase ◽  
Asymptomatic Children

AbstractObjectiveTo quantify myocardial blood flow in infants and children with mild or moderate aortic stenosis using adenosine-infusion cardiac magnetic resonance.BackgroundIt is unclear whether asymptomatic children with mild/moderate aortic stenosis have myocardial abnormalities. In addition, cardiac magnetic resonance-determined normative myocardial blood flow data in children have not been reported.MethodsWe studied 31 infants and children with either haemodynamically normal hearts (n=20, controls) or mild/moderate aortic stenosis (n=11). The left ventricular myocardium was divided into six segments, and the change in average segmental signal intensity during contrast transit was used to quantify absolute flow (ml/g/minute) at rest and during adenosine infusion by deconvolution of the tissue curves with the arterial input of contrast.ResultsIn all the cases, adenosine was well tolerated without complications. The mean pressure gradient between the left ventricle and the ascending aorta was higher in the aortic stenosis group compared with controls (24 versus 3 mmHg, p<0.001). Left ventricular wall mass was slightly higher in the aortic stenosis group compared with controls (65 versus 50 g/m2, p<0.05). After adenosine treatment, both the absolute increase in myocardial blood flow (p<0.0001) and the hyperaemic flow significantly decreased (p<0.001) in children with mild/moderate aortic stenosis compared with controls.ConclusionAbnormal myocardial blood flow in children with mild/moderate aortic stenosis may be an important therapeutic target.

scholarly journals Quantitative cardiovascular magnetic resonance myocardial perfusion mapping to assess hyperaemic response to adenosine stress

2020 ◽  
Author(s):  
Tushar Kotecha ◽  
Juan Manuel Monteagudo ◽  
Ana Martinez-Naharro ◽  
Liza Chacko ◽  
James Brown ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Myocardial Blood Flow ◽  
Adenosine Stress ◽  
Coronary Physiology ◽  
Derivation Cohort ◽  
Clinical Cohort ◽  
Hyperaemic Response ◽  
Stress Cmr

Abstract Aims Assessment of hyperaemia during adenosine stress cardiovascular magnetic resonance (CMR) remains a clinical challenge with lack of a gold-standard non-invasive clinical marker to confirm hyperaemic response. This study aimed to validate maximum stress myocardial blood flow (SMBF) measured using quantitative perfusion mapping for assessment of hyperaemic response and compare this to current clinical markers of adenosine stress. Methods and results Two hundred and eighteen subjects underwent adenosine stress CMR. A derivation cohort (22 volunteers) was used to identify a SMBF threshold value for hyperaemia. This was tested in a validation cohort (37 patients with suspected coronary artery disease) who underwent invasive coronary physiology assessment on the same day as CMR. A clinical cohort (159 patients) was used to compare SMBF to other physiological markers of hyperaemia [splenic switch-off (SSO), heart rate response (HRR), and blood pressure (BP) fall]. A minimum SMBF threshold of 1.43 mL/g/min was derived from volunteer scans. All patients in the coronary physiology cohort demonstrated regional maximum SMBF (SMBFmax) &gt;1.43 mL/g/min and invasive evidence of hyperaemia. Of the clinical cohort, 93% had hyperaemia defined by perfusion mapping compared to 71% using SSO and 81% using HRR. There was no difference in SMBFmax in those with or without SSO (2.58 ± 0.89 vs. 2.54 ± 1.04 mL/g/min, P = 0.84) but those with HRR had significantly higher SMBFmax (2.66 1.86 mL/g/min, P &lt; 0.001). HRR &gt;15 bpm was superior to SSO in predicting adequate increase in SMBF (AUC 0.87 vs. 0.62, P &lt; 0.001). Conclusion Adenosine-induced increase in myocardial blood flow is accurate for confirmation of hyperaemia during stress CMR studies and is superior to traditional, clinically used markers of adequate stress such as SSO and BP response.

scholarly journals The feasibility of SPECT CZT measurement of myocardial blood flow and reserve in patients with acute coronary syndrome: comparison with cardiac magnetic resonance

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
K Zavadovskiy ◽  
O Mochula ◽  
A Maltseva ◽  
D Vorobyeva ◽  
A Mochula ◽  
...  
Keyword(s):  
Blood Flow ◽  
Acute Coronary Syndrome ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Myocardial Blood Flow ◽  
Myocardial Injury ◽  
Dynamic Spect ◽  
Coronary Syndrome ◽  
Flow Reserve ◽  
Myocardial Flow

Abstract Funding Acknowledgements Type of funding sources: None. Background. Myocardial infarction with non-obstructive coronary arteries (MINOCA) is currently of interest in terms of diagnostic and treatment strategy. The diagnosis of MINOCA has been included in the STEMI guidelines of the European Society of Cardiology. However, there is lack of data regarding the relationship between myocardial damage according to cardiac magnetic resonance (CMR) and myocardial blood flow (MBF), myocardial flow reserve (MFR) obtained by dynamic SPECT. Purpose. To elucidate impairment of myocardial perfusion, MBF and MFR in patients with MINOCA. Methods. The study included 31 patients (21 men, age 62(56;70) years) with ASC. According to electrocardiography, cardiac biomarkers, invasive coronary angiography two groups were identified: with non-obstructive coronary arteries MINOCA (n = 10); MICAD (n = 21). Within 7-14 days after admission to the hospital all patients underwent dynamic SPECT on CZT gamma-camera with the assessment of standard indices of myocardial perfusion (SSS, SRS, SDS) and quantitative parameters (stress/rest myocardial blood flow (s/r MBF), myocardial flow reserve (MFR)). All patients underwent CMR with late gadolinium enhancement as well. Infarct size (IS), microvascular obstruction (MVO) and myocardial edema size (ME) were evaluated. Results. SSS and SRS differed significantly (p &lt; 0.05) in MINOCA and MICAD patients: MINOCA: SSS 5.0(3.0;5.0), SRS 2.0(1.0;3.0); MICAD: SSS 9.0(5.0;13.0), SRS 6.0(3.0;11.0). However, SDS did not differ significantly in these two groups 2.5(1.0;4.0) vs 4.0(2.0;5.0). Moreover MINOCA patients in comparison with those with MIACD had higher values of quantitative parameters (p &lt; 0.05): sMBF 2.02 (1.71;2.37) vs 0.86 (0.72;1.02) ml/min/g, rMBF 0.68 (0.66;0.86) vs 0.49 (0.4;0.57) ml/min/g, MFR 2.61 (2.23;3.14) vs 1.67 (1.1;1.9), respectively. Based on CMR, a total of 93 left ventricular vessel territories were analyzed. A total of 36(39%) vessel territories were considered as having acute myocardial injury (5 in MICAD, 31 in MINOCA). In patients with MICAD the values of IS, ME were significantly higher as compared to those with MINOCA (IS: 19.4(10.4;29.7)% vs1.8(0.0;6.9)%, ME: 19.5(12.0;30.0)% vs 3.0(0.0;12.0)% - p &lt; 0.01). Based on regional analysis sMBF and MFR were significantly lower in vessel territories considering as CMR positive compared to those without MR signs of myocardial injury: regional sMBF 0.98(0.73;1.79) vs 1.33(0.94;2.08); regional MFR 0.58(0.43;0.9) vs 0.71(0.57;0.88), respectively. Conclusion. SPECT CZT is feasible in identifying both global and regional disturbances of myocardial blood flow and reserve in patients with acute coronary syndrome. MINOCA patients are characterized by mild reduction of myocardial blood flow and perfusion assessed visually and quantitatively. Therefore despite the absence of obstructive coronary artery lesion this group of patients has more pronounced risk of cardiac events and need more aggressive observation and treatment.

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