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February 1, 2018Journal of Cardiovascular Magnetic ResonanceOpen Access

Quantitative cardiovascular magnetic resonance perfusion imaging identifies reduced flow reserve in microvascular coronary artery disease

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Key result

Patients with angina, risk factors for microvascular disease, and no obstructive coronary artery disease had significantly reduced myocardial perfusion reserve compared to healthy controls (median 2.21 vs. 2.93, p < 0.001).

Why the study?

Does fully quantitative CMR perfusion imaging identify reduced myocardial perfusion reserve in patients with angina and risk factors for microvascular disease compared to healthy controls?

Population

46 patients with typical angina and risk factors for microvascular disease who had no obstructive coronary…

Comparison

Regadenoson stress cardiovascular magnetic… vs Healthy control subjects

Design

Case-control

Authors

BZBenjamin ZorachPSP.W. ShawJBJamieson M. Bourque

Discussion

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Overview

May aid detection of microvascular dysfunction via quantitative CMR in angina without obstructive CAD; hypothesis-generating, should not yet change practice.

Study Design

Type

Cross-Sectional (n=66)

Multicenter

No

Structured PICO

Does fully quantitative CMR perfusion imaging identify reduced myocardial perfusion reserve in patients with angina and risk factors for microvascular disease compared to healthy controls?

P
Population
66 participants, comprising 46 patients with typical angina, risk factors for microvascular disease, and no obstructive coronary artery disease, and 20 healthy controls, evaluated using quantitative cardiovascular magnetic resonance perfusion imaging.
E
Exposure
Regadenoson stress cardiovascular magnetic resonance (CMR) perfusion imaging using a dual-sequence quantitative spiral pulse sequence, T1 mapping, and CT coronary calcium scoring
C
Comparator
Healthy control subjects
O
Outcome
Myocardial perfusion reserve (MPR) and stress myocardial perfusionsurrogate

Main Result

Absolute Event Rate: 2.21% vs 2.93%

p-value: p=<0.001

Fully quantitative CMR perfusion imaging identifies reduced myocardial perfusion reserve in patients with angina and risk factors for microvascular disease, independent of myocardial hypertrophy or fibrosis.

Limitations

  • Invasive coronary flow reserve and coronary reactivity testing were not acquired at the time of angiography to validate the diagnosis of MVD.
  • The control group had a lower mean BMI than the study group.
  • Small sample size limits detailed subgroup analysis.

Cite This Study

Zorach et al. (2018) conducted a cross-sectional in Microvascular coronary artery disease (n=66). Microvascular disease risk factors without obstructive CAD vs. Healthy controls was evaluated on Myocardial perfusion reserve (MPR) (p=<0.001). Patients with angina, risk factors for microvascular disease, and no obstructive coronary artery disease had significantly reduced myocardial perfusion reserve compared to healthy controls (median 2.21 vs. 2.93, p < 0.001).

synapsesocial.com/papers/6a22ff52a0586e7822f72702https://doi.org/10.1186/s12968-018-0435-1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiac magnetic resonance imaging myocardial perfusion reserve index assessment in women with microvascular coronary dysfunction and reference controls.2013 · 59 citations
  2. 2Coronary microvascular function and myocardial fibrosis in women with angina pectoris and no obstructive coronary artery disease: the iPOWER study2016 · 38 citations
  3. 3Cardiovascular magnetic resonance detects the progression of impaired myocardial perfusion reserve and increased left-ventricular mass in mice fed a high-fat diet2016 · 36 citations
  4. 4Coronary Microvascular Reactivity to Adenosine Predicts Adverse Outcome in Women Evaluated for Suspected Ischemia2010 · 809 citations
  5. 5Repeatability of Rest and Hyperemic Myocardial Blood Flow Measurements with <sup>82</sup>Rb Dynamic PET2008 · 94 citations