Quantification of myocardial oxygen consumption and myocardial external efficiency using cardiac MRI: a pilot study in post-MI HFrEF patients

Motivation: Myocardial external efficiency (MEE) relating the left ventricular (LV) mechanical energetic output to myocardial oxidative metabolism demonstrates the efficiency of LV performance. Goal(s): Explore the feasibility of a newly developed non-invasive and radiation-free cardiac magnetic resonance (CMR) technique for MEE in patients with heart failure (HF) following myocardial infarction (MI). Approach: A prospective single institutional study enrolling post-MI HF patients and control subjects who received a high-resolution, non-ECG gated and free-breathing GRE T2-weighted inversion recovery MR oximetry sequence. Results: MEE derived by CMR demonstrated moderate correlations between EF and myocardial strain and was lower in patients compared to control subjects. Impact: The non-invasive and radiation-free GRE T2-weighted inversion recovery CMR technique can evaluate myocardial oxidative embolism and assess myocardial performance efficiency, which is lower in post-MI HF patients.