Key result
Idiopathic dilated cardiomyopathy is linked to ~29% lower global CFR versus risk-matched controls.
Why the study?
To compare global coronary flow reserve between patients with idiopathic dilated cardiomyopathy and risk-matched controls using CMR, and evaluate its relationship with CMR left ventricular parameters.
Does global coronary flow reserve differ between patients with idiopathic dilated cardiomyopathy and risk-matched controls, and how does it relate to LV parameters?
Case-Control (n=52)
No
Does global coronary flow reserve differ between patients with idiopathic dilated cardiomyopathy and risk-matched controls, and how does it relate to LV parameters?
Global coronary flow reserve is significantly impaired in patients with idiopathic DCM and is independently associated with LV global longitudinal strain, suggesting microvascular dysfunction contributes to LV deterioration.
May signal microvascular dysfunction in DCM progression; extends CFR-GLS link but remains hypothesis-generating.
PURPOSE: The purposes of this study were to compare global coronary flow reserve (CFR) between patients with idiopathic dilated cardiomyopathy (DCM) and risk-matched controls using cardiac MRI (CMR), and to evaluate the relationship between global CFR and CMR left ventricular (LV) parameters. METHODS: Twenty-six patients with DCM and 26 risk-matched controls who underwent comprehensive CMR examination, including stress-rest coronary sinus flow measurement by phase contrast (PC) cine CMR were retrospectively studied. LV peak global longitudinal, radial, and circumferential strains (GLS, GRS, and GCS) were determined by feature tracking. RESULTS: Patients with DCM had significantly lower global CFR compared with the risk-matched controls (2.87 ± 0.86 vs. 4.03 ± 1.47, P = 0.001). Among the parameters, univariate linear regression analyses revealed significant correlation of global CFR with LV end-diastolic volume index (r = -0.396, P = 0.045), LV mass index (r = -0.461, P = 0.018), GLS (r = -0.558, P = 0.003), and GRS (r = 0.392, P = 0.047). Multiple linear regression analysis revealed GLS as the only independent predictor of global CFR (standardized β = -0.558, P = 0.003). CONCLUSION: Global CFR was significantly impaired in patients with idiopathic DCM and independently associated with LV GLS, suggesting that microvascular dysfunction may contribute to deterioration of LV function in patients with idiopathic DCM.
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Takafuji et al. (2023) conducted a case-control in Idiopathic Dilated Cardiomyopathy (n=52). Idiopathic Dilated Cardiomyopathy vs. Risk-matched controls was evaluated on Global coronary flow reserve (CFR) (p=0.001). Patients with idiopathic dilated cardiomyopathy had significantly lower global coronary flow reserve compared to risk-matched controls (2.87 vs. 4.03, P=0.001).
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