Author + information
- Behzad Sharif,
- Daniel Berman,
- Rohan Dharmakumar and
- C. Noel Bairey Merz
It has been established that a significant portion of patients with signs and symptoms of ischemia but normal angiograms suffer from coronary microvascular dysfunction (CMD). Reliable diagnosis of CMD on the basis of first-pass perfusion (FPP) MRI is an ongoing challenge. We hypothesized that high-resolution FPP imaging can detect diffuse subendocardial defects and transmural perfusion gradients (TPGs) consistent with CMD in a swine model.
Yucatan mini-pigs (n=10) were fed either a high-fat high-sugar diet (n=4 “HFHS” group) or normal chow (“control” group). Compared to controls, the HFHS pigs were obese, had elevated fasting glucose and expected to have CMD based on previous studies. Obstructive CAD was angiographically ruled out. FPP data was acquired using a novel MRI method with optimized radial sampling enabling end-systolic imaging at 1.2 mm resolution.
Visual assessment of stress images showed normal perfusion in the control group but a delayed wash-in of contrast in the subendocardium for all HFHS pigs (Fig. 1). TPG analysis (Chiribiri JACC Imaging 2013) demonstrated a significantly higher mean TPG in HFHS pigs vs controls (24%±5% vs 6%±3%).
We demonstrated that subendocardial ischemia and stress-induced TPGs can be visually detected in the absence of obstructive CAD using an optimized high-resolution end-systolic FPP method. Our results suggest that this methodology may be a promising approach for accurate diagnosis of CMD in clinical settings.
Poster Area, South Hall A1
Saturday, April 02, 2016, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: MR Cardiac Structure and Function
Abstract Category: 30. Non Invasive Imaging: MR
Presentation Number: 1151-261
- 2016 American College of Cardiology Foundation