Adenosine myocardial contrast echo in intermediate severity coronary stenoses: a prospective two-center study

Firschke, Christian; Andrássy, Péter; Linka, André; Busch, Raymonde; Martinoff, Stefan

doi:10.1007/s10554-006-9157-9

Cited by 10 publications

(15 citation statements)

References 28 publications

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“…Systolic blood pressure showed significant elevation only at 1 and 5 min after the start of adenosine infusion. The increase in RPP with the vasodilation agent adenosine is not unusual as this was also reported by others [19,20]. Figure 2 shows examples of T 2 -weighted images of the coronary sinus of one volunteer using the T 2 prep sequence.…”

Section: Resultssupporting

confidence: 74%

Quantification of global myocardial oxygenation in humans: initial experience

McCommis

O’Connor

Lesniak

et al. 2010

Journal of Cardiovascular Magnetic Resonance

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PurposeTo assess the feasibility of our newly developed cardiovascular magnetic resonance (CMR) methods to quantify global and/or regional myocardial oxygen consumption rate (MVO2) at rest and during pharmacologically-induced vasodilation in normal volunteers.MethodsA breath-hold T2 quantification method is developed to calculate oxygen extraction fraction (OEF) and MVO2 rate at rest and/or during hyperemia, using a two-compartment model. A previously reported T2 quantification method using turbo-spin-echo sequence was also applied for comparison. CMR scans were performed in 6 normal volunteers. Each imaging session consisted of imaging at rest and during adenosine-induced vasodilation. The new T2 quantification method was applied to calculate T2 in the coronary sinus (CS), as well as in myocardial tissue. Resting CS OEF, representing resting global myocardial OEF, and myocardial OEF during adenosine vasodilation were then calculated by the model. Myocardial blood flow (MBF) was also obtained to calculate MVO2, by using a first-pass perfusion imaging approach.ResultsThe T2 quantification method yielded a hyperemic OEF of 0.37 ± 0.05 and a hyperemic MVO2 of 9.2 ± 2.4 μmol/g/min. The corresponding resting values were 0.73 ± 0.05 and 5.2 ± 1.7 μmol/g/min respectively, which agreed well with published literature values. The MVO2 rose proportionally with rate-pressure product from the rest condition. The T2 sensitivity is approximately 95% higher with the new T2 method than turbo-spin-echo method.ConclusionThe CMR oxygenation method demonstrates the potential for non-invasive estimation of myocardial oxygenation, and should be explored in patients with altered myocardial oxygenation.

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Section: Resultssupporting

confidence: 74%

Quantification of global myocardial oxygenation in humans: initial experience

McCommis

O’Connor

Lesniak

et al. 2010

Journal of Cardiovascular Magnetic Resonance

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“…In addition to these animal studies, studies are also on the way to gain the understanding of different roles of MBV and MBF in cardiac patients. Changes in MBV appeared to be associated with the perfusion states of intermediate coronary artery stenosis [24] and the changes in MVO 2 [25]. These techniques thus could provide a comprehensive evaluation of coronary stenosis severity [26].…”

Section: Mbf and Mbvmentioning

confidence: 87%

Quantifying Myocardial Oxygenation with Cardiac Magnetic Resonance Imaging

Muccigrosso¹,

Zheng

2012

TOMIJ

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Myocardial ischemia, resulting from imbalance in myocardial oxygen supply and demand, can be quantitatively assessed by positron emission tomography (PET) with absolute measures of myocardial blood flow and oxygen consumption rate (MVO 2 ). Cardiac Magnetic Resonance (CMR) has notable advantages over PET, with no radiation, high spatial resolution, faster scan times, and excellent soft tissue contrast. We have developed and validated new quantitative CMR oximetry techniques, including measurements of hyperemic myocardial oxygen extraction fraction and MVO 2 through Fick's Law. These may lead to a new understanding of roles of myocardial microcirculation in myocardial ischemia. Other cardiac oximetry methods for directly quantifying MVO 2 with 17 O-labelled water are also under investigation. Quantitative CMR oximetry is a promising, non-invasive, non-radiation approach for exploring the myocardial metabolism's role in cardiac patients.

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“…During dipyridamole vasodilation, stenosis reduced MFR significantly without much decrease in MVR, although both reserves in the remote LCx regions were significantly greater than in post-stenosis LAD regions. This suggests that, without much change in global oxygen demand, myocardial capillary perfusion is not strongly associated with myocardial capillary blood volume or MBV and MBF increases are solely mediated by an increase in blood velocity due to arteriolar vasodilation, as suggested by MCE studies in dogs [4] and humans [6]. …”

Section: Discussionmentioning

confidence: 98%

“…Specifically, changes in MBV have outstripped the changes in MBF in settings of greatly elevated myocardial oxygen consumption. In a two-center study with qualitative analysis, MBV appeared to be associated with the functional relevance of coronary artery stenosis [6] and myocardial oxygen consumption (MVO 2 ) [7], and may provide a comprehensive evaluation of coronary stenosis severity [8]. …”

Section: Introductionmentioning

confidence: 99%

Roles of myocardial blood volume and flow in coronary artery disease: an experimental MRI study at rest and during hyperemia

et al. 2010

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Objective-To validate fast perfusion mapping techniques in a setting of coronary artery stenosis, and to further assess the relationship of absolute myocardial blood volume (MBV) and blood flow (MBF) to global myocardial oxygen demand.Methods-A group of 27 mongrel dogs were divided into 10 controls and 17 with acute coronary stenosis. On 1.5-T MRI, first-pass perfusion imaging with a bolus injection of a blood-pool contrast agent was performed to determine myocardial perfusion both at rest and during either dipyridamoleinduced vasodilation or dobutamine-induced stress. Regional values of MBF and MBV were quantified by using a fast mapping technique. Color microspheres and 99m Tc-labeled red blood cells were injected to obtain respective gold standards. Results NIH Public Access Author ManuscriptEur Radiol. Author manuscript; available in PMC 2011 August 1. Under dobutamine stress, MBV shows better association with total myocardial oxygen demand than MBF. Coronary stenosis progressively reduced this association in the presence of increased stenosis severity.Conclusions-MR first-pass perfusion can rapidly estimate regional MBF and MBV. Absolute quantification of MBV may add additional information on stenosis severity and myocardial viability compared with standard qualitative clinical evaluations of myocardial perfusion.

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Adenosine myocardial contrast echo in intermediate severity coronary stenoses: a prospective two-center study

Abstract: Assessment of myocardial blood volume changes during adenosine using MCE can be used for the determination of the functional relevance of coronary stenoses of intermediate angiographic severity if MVO2 is increased during adenosine.

Cited by 10 publications

References 28 publications

Quantification of global myocardial oxygenation in humans: initial experience

Quantification of global myocardial oxygenation in humans: initial experience

Quantifying Myocardial Oxygenation with Cardiac Magnetic Resonance Imaging

Roles of myocardial blood volume and flow in coronary artery disease: an experimental MRI study at rest and during hyperemia

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