Key result
Adenosine infusion significantly increased the subendocardial myocardial perfusion index from 0.091 at rest to 0.143 (P<0.001) in patients with chest pain and normal coronary angiograms.
Why the study?
Is subendocardial hypoperfusion present on cardiovascular MRI during adenosine infusion in patients with chest pain and normal coronary angiograms?
Observational (n=20)
Is subendocardial hypoperfusion present on cardiovascular MRI during adenosine infusion in patients with chest pain and normal coronary angiograms?
Absolute Event Rate: 0.143% vs 0.091%
p-value: p=<0.001
In patients with angina and normal coronary angiograms, cardiovascular MRI showed normal perfusion responses to adenosine, finding no evidence of subendocardial hypoperfusion.
Normal CMR perfusion response to adenosine in angina with normal coronaries; leaves open symptom mechanisms and requires prospective validation.
AIMS: On the basis of an MRI study it has been suggested that subendocardial hypoperfusion is present in patients with cardiac syndrome X. However, further work is required to test whether these findings can be generalized. METHODS AND RESULTS: MRI was used to visually and semi-quantitatively assess subendocardial and subepicardial perfusion, at rest and during an infusion of adenosine, in 20 patients with angina pectoris and normal coronary angiograms. A myocardial perfusion index (MPI) was calculated using the normalized upslope of myocardial signal enhancement. An index for myocardial perfusion reserve (MPRI) was calculated by dividing the MPI values at maximal vasodilatation by the values at rest. The MPI in our study population increased significantly during adenosine infusion in both the subendocardium (from 0.091 +/- 0.020 to 0.143 +/- 0.030; P < 0.001) and the subepicardium (from 0.074 +/- 0.017 to 0.135 +/- 0.03; P < 0.001). The overall MPRI was 1.83 +/- 0.50. CONCLUSION: The results show that patients with chest pain and normal coronary angiograms had significant perfusion responses to adenosine in both the subendocardium and subepicardium. In the present study we found no evidence for subendocardial hypoperfusion in these patients.
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Vermeltfoort et al. (2007) conducted an observational in Angina pectoris with normal coronary angiograms (n=20). Adenosine infusion vs. Rest was evaluated on Subendocardial myocardial perfusion index (MPI) (p=<0.001). Adenosine infusion significantly increased the subendocardial myocardial perfusion index from 0.091 at rest to 0.143 (P<0.001) in patients with chest pain and normal coronary angiograms.
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