Author + information
- Behzad Sharif,
- Ahmed Al Badri,
- Janet Wei,
- Babak Azarbal,
- Bruce Samuels,
- Debiao Li,
- Daniel Berman and
- C. Noel Bairey Merz
Background: Nearly 50% of women with symptoms of ischemia suffer from coronary microvascular dysfunction (CMD) in the absence of obstructive coronary disease. In this cohort, a common mechanistic pathway involves dysfunction of coronary endothelium. It is not known whether variables derived from magnetic resonance (MR) perfusion imaging can detect endothelial dysfunction. We hypothesized that myocardial blood flow (MBF) gradients are associated with the invasive measure of endothelial function in CMD.
Methods: Eleven women with no angiographic disease (<50% stenosis) underwent invasive coronary reactivity testing. Microvascular endothelial function was assessed based on the coronary blood flow (CBF) change in response to intracoronary Acetylcholine (ACh), with <50% CBF increase considered abnormal. The hyperemic MBF gradient was defined as the ratio of subendocardial-to-subepicardial MBF measured using high-resolution adenosine-stress MR.
Results: Four cases were excluded from the analysis due to abnormal intracoronary Nitroglycerin response, indicative of endothelial-independent macrovascular dysfunction. Fig. 1A shows example MR results. As described in Fig. 1B, the hyperemic MBF gradient was notably reduced in cases with abnormal ACh CBF response.
Conclusions: Our initial results suggest that the hyperemic perfusion gradient measured using MR may be used as a noninvasive surrogate of the established invasive marker for endothelial dysfunction in patients with suspected CMD.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: MR Scar and Perfusion
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1244-199
- 2017 American College of Cardiology Foundation