Women with microvascular coronary dysfunction had significantly lower global myocardial perfusion reserve index values measured by CMRI compared to reference controls (1.63 vs. 1.98, P=0.007).
Case-Control (n=65)
No
Does adenosine CMRI detect differences in myocardial perfusion reserve index between women with microvascular coronary dysfunction and reference controls?
Adenosine CMRI demonstrates lower myocardial perfusion reserve index in women with microvascular coronary dysfunction compared to controls, suggesting its potential as a non-invasive diagnostic tool.
Absolute Event Rate: 1.63% vs 1.98%
p-value: p=0.007
OBJECTIVE: We sought to comparatively assess cardiac magnetic resonance imaging (CMRI) myocardial perfusion reserve index (MPRI) in women with confirmed microvascular coronary dysfunction (MCD) cases and reference control women. BACKGROUND: Women with signs or symptoms of myocardial ischemia in the absence of obstructive coronary artery disease (CAD) frequently have MCD which carries an adverse prognosis. Diagnosis involves invasive coronary reactivity testing (CRT). Adenosine CMRI is a non-invasive test that may be useful for the detection of MCD. METHODS: Fifty-three women with MCD confirmed by CRT and 12 age- and estrogen-use matched reference controls underwent adenosine CMRI. CMRI was assessed for MPRI, calculated using the ratio of myocardial blood flow at hyperemia/rest for the whole myocardium and separately for the 16 segments as defined by the American Heart Association. Statistical analysis was performed using repeated measures ANOVA models. RESULTS: Compared to reference controls, MCD cases had lower MPRI values globally and in subendocardial and subepicardial regions (1.63±0.39 vs. 1.98±0.38, P=0.007, 1.51±0.35 vs. 1.84±0.34, P=0.0045, 1.68±0.38 vs. 2.04±0.41, P=0.005, respectively). A perfusion gradient across the myocardium with lower MPRI in the subendocardium compared to the subepicardium was observed for both groups. CONCLUSIONS: Women with MCD have lower MPRI measured by perfusion CMRI compared to reference controls. CMRI may be a useful diagnostic modality for MCD. Prospective validation of a diagnostic threshold for MPRI in patients with MCD is needed.
Shufelt et al. (Sun,) conducted a case-control in Microvascular coronary dysfunction (MCD) (n=65). Adenosine cardiac magnetic resonance imaging (CMRI) vs. Asymptomatic reference controls was evaluated on Global myocardial perfusion reserve index (MPRI) (p=0.007). Women with microvascular coronary dysfunction had significantly lower global myocardial perfusion reserve index values measured by CMRI compared to reference controls (1.63 vs. 1.98, P=0.007).