Patients with chronic heart failure had severely reduced coronary flow reserve compared with healthy volunteers (2.3 ± 0.9 vs 4.2 ± 1.5, P=0.01) and depressed LV perfusion after vasodilation.
Cross-Sectional (n=20)
Does velocity-encoded cine MR imaging detect differences in global LV perfusion and coronary flow reserve between patients with chronic heart failure and healthy volunteers?
Velocity-encoded cine MR imaging demonstrates that patients with chronic heart failure have normal resting LV perfusion but severely impaired coronary flow reserve after vasodilation.
Absolute Event Rate: 2.3% vs 4.2%
p-value: p=0.01
PURPOSE: To quantify and compare global left ventricular (LV) perfusion and coronary flow reserve (CFR) in patients with chronic heart failure and in healthy volunteers by measuring coronary sinus flow with velocity-encoded cine (VEC) magnetic resonance (MR) imaging. MATERIALS AND METHODS: MR measurements were performed in 10 consecutive patients with chronic heart failure due to coronary artery disease and in 10 volunteers. Global LV perfusion was quantified by measuring coronary sinus flow in an oblique imaging plane perpendicular to the coronary sinus with non-breath-hold VEC MR imaging. LV mass was measured by means of cine imaging that encompassed the heart. LV perfusion was calculated from coronary sinus flow and mass. CFR was measured from LV perfusion at rest and that after infusion of dipyridamole. Analysis of covariance was used to determine differences between groups. Differences within groups were analyzed by means of the Student t test for paired data. Regression analysis was used to determine correlation between CFR and LV ejection fraction. RESULTS: At rest, LV perfusion was not significantly different in patients with chronic heart failure (0.46 mL/min/g +/- 0.19) and volunteers (0.52 mL/min/g +/- 0.21, P =.54). After administration of dipyridamole, LV perfusion was less than half in patients with chronic heart failure compared with that in volunteers (1.07 mL/min/g +/- 0.64 vs 2.19 mL/min/g +/- 0.98) (P =.03). CFR was severely reduced in patients with chronic heart failure compared with that in volunteers (2.3 +/- 0.9 vs 4.2 +/- 1.5, P =.01). A moderate but significant correlation was found between CFR and LV ejection fraction (r = 0.54, P =.02) CONCLUSION: Combined cine and VEC MR imaging revealed that patients with chronic heart failure have normal LV perfusion at rest but severely depressed LV perfusion after vasodilation. Impaired CFR may contribute to progressive decline in LV function in patients with chronic heart failure.
Lund et al. (Tue,) conducted a cross-sectional in Chronic heart failure (n=20). Chronic heart failure vs. Healthy volunteers was evaluated on Coronary flow reserve (CFR) (p=0.01). Patients with chronic heart failure had severely reduced coronary flow reserve compared with healthy volunteers (2.3 ± 0.9 vs 4.2 ± 1.5, P=0.01) and depressed LV perfusion after vasodilation.
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