Key result
MINOCA is linked to reduced LV direct flow of ~ on 4D-flow CMR.
Why the study?
The mechanisms of MINOCA are incompletely understood, and it was uncertain whether patients with MINOCA demonstrate impaired early diastolic filling efficiency as quantified by early filling blood kinetic energy on 4D flow CMR.
Does four-dimensional flow cardiovascular magnetic resonance identify impaired early diastolic filling efficiency and altered left ventricular flow energetics in patients with MINOCA compared to healthy controls?
Case-Control (n=96)
Does four-dimensional flow cardiovascular magnetic resonance identify impaired early diastolic filling efficiency and altered left ventricular flow energetics in patients with MINOCA compared to healthy controls?
4D flow CMR reveals that 74% of MINOCA patients exhibit impaired early diastolic ventricular filling efficiency and altered blood kinetic energy, suggesting underlying abnormalities in myocardial relaxation and microvascular function.
Answers are grounded in this paper and cite their sources.
Supports diastolic assessment in MINOCA; leaves open 4D flow CMR adoption pending prospective validation.
Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous condition with incompletely understood mechanisms. Early diastolic filling contributes to ventricular efficiency and reflects myocardial relaxation and compliance, which may be altered by coronary microvascular dysfunction. Purpose We aimed to determine whether patients with MINOCA demonstrate impaired early diastolic filling efficiency, quantified by early filling blood kinetic energy using four-dimensional flow cardiovascular magnetic resonance (4D flow CMR). Methods 46 MINOCApatients and 50 healthy controls without known cardiovascular disease were included in this study, and all underwentcine and 4D flow MRI. Using MASS software, automated segmentation of the LV endocardial and epicardial borders was performed using an artificial intelligence–based algorithm to derive conventional LV volumes and myocardial mass, with manual adjustments performed when necessary, according to Society for Cardiovascular Magnetic Resonance recommendations. Four LV flow components (direct flow, retained inflow, delayed ejection flow and residual volume) and LV kinetic energy parameters normalized to LV end-diastolic volume (KEiEDV) were derived. Results See Table. Compared with controls, patients with MINOCA exhibited marked alterations in LV flow energetics, characterized by reduced LV direct flow (15% vs. 33%, P<0.001) and increased LV residual volume (47% vs. 35%, P<0.001), together with significantly decreased KEiEDV parameters. Peak E-wave KEiEDV demonstrated excellent discriminatory performance for identifying MINOCA (AUC = 0.898). Applying a threshold derived from the control population (mean − 1 SD; 12.50 μJ/mL), impaired early filling efficiency was detected in 74% of MINOCA patients. Conclusion These findings indicate that a substantial proportion of MINOCA patients have reduced early diastolic blood kinetic energy, reflecting impaired ventricular filling efficiency and potentially underlying abnormalities in myocardial relaxation, ventricular compliance, and coronary microvascular function.
No takes yet. Share an insight, caveat, or question.
Zhao et al. (2026) conducted a case-control in Myocardial infarction with non-obstructive coronary arteries (MINOCA) (n=96). Myocardial infarction with non-obstructive coronary arteries (MINOCA) vs. Healthy controls without known cardiovascular disease was evaluated on Left ventricular direct flow and residual volume / early filling blood kinetic energy normalized to LV end-diastolic volume (KEiEDV) (AUC 0.898 (Peak E-wave KEiEDV), p=<0.001). MINOCA patients exhibited reduced LV direct flow, increased residual volume, and impaired early filling efficiency in 74% on 4D flow CMR.
Synapse has enriched 10 related papers. Consider them for comparative context: