Key result
Systolic FAIR with 2-cycle delay boosts exercise-stress TSNR ~63% over 1-cycle delay.
Why the study?
Feasibility of systolic flow-sensitive alternating inversion recovery (FAIR) during rest and exercise stress with different RR intervals for non-contrast myocardial perfusion assessment was not established.
Can systolic flow-sensitive alternating inversion recovery (FAIR) MRI detect changes in myocardial blood flow during exercise stress compared to rest in healthy subjects?
Observational (n=10)
No
Can systolic flow-sensitive alternating inversion recovery (FAIR) MRI detect changes in myocardial blood flow during exercise stress compared to rest in healthy subjects?
Absolute Event Rate: 7.36% vs 4.52%
p-value: p=<0.001
Systolic FAIR MRI with a 2RR delay is a feasible non-contrast technique for assessing myocardial perfusion during exercise stress, providing relatively high temporal signal-to-noise ratio.
May support non-contrast exercise-stress perfusion MRI in healthy subjects; leaves open validation in patients and against reference standards.
Objective: To evaluate systolic flow-sensitive alternating inversion recovery (FAIR) during rest and exercise stress using 2RR (two cardiac cycles) or 1RR intervals between inversion pulse and imaging. Materials and Methods: 1RR and 2RR FAIR was implemented on a 3T scanner. Ten healthy subjects were scanned during rest and stress. Stress was performed using an in-bore ergometer. Heart rate, mean myocardial blood flow (MBF) and temporal signal-to-noise ratio (TSNR) were compared using paired t-tests. Results: Mean heart rate during stress was higher than rest for 1RR FAIR (85.8±13.7bpm vs 63.3±11.1bpm; p<0.01) and 2RR FAIR (83.8±14.2bpm vs 63.1±10.6bpm; p<0.01). Mean stress MBF was higher than rest for 1RR FAIR (2.97±0.76ml/g/min vs 1.43±0.6 ml/g/min; p<0.01) and 2RR FAIR (2.8±0.96 ml/g/min vs 1.22±0.59 ml/g/min; p<0.01). Resting mean MBF was higher for 1RR FAIR than 2RR FAIR (p<0.05), but not during stress. TSNR was lower for stress compared to rest for 1RR FAIR (4.52±2.54 vs 10.12±3.69; p<0.01) and 2RR FAIR (7.36±3.78 vs 12.41±5.12; p<0.01). 2RR FAIR TSNR was higher than 1RR FAIR for rest (p<0.05) and stress (p<0.001). Discussion: We have demonstrated feasibility of systolic FAIR in rest and exercise stress. 2RR delay systolic FAIR enables non-contrast perfusion assessment during stress with relatively high TSNR.
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Henningsson et al. (2021) conducted an observational in Healthy volunteers (n=10). 2RR systolic FAIR MRI vs. 1RR systolic FAIR MRI was evaluated on Temporal signal-to-noise ratio (TSNR) during exercise stress (p=<0.001). Systolic flow-sensitive alternating inversion recovery (FAIR) with a 2-cardiac-cycle delay significantly improved temporal signal-to-noise ratio during exercise stress compared to a 1-cycle delay.
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