Sub-endocardial and sub-epicardial measurement of myocardial blood flow using 13NH3 PET in man

Sciagrà, Roberto; Milan, Elisa; Giubbini, Raffaele; Kubik, Tomasz; Dato, Rossella Di; Gallo, L; Camoni, Luca; Allocca, Michela; Calabretta, Raffaella

doi:10.1007/s12350-018-1445-y

Cited by 8 publications

(1 citation statement)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is consistent with previous microsphere studies using animal models30 31 and CMR studies in health and disease 32 33. In contrast, PET studies have suggested that at stress the subendocardium is more highly perfused than the subepicardium 34 35. Possible explanations include differences in the spatial resolution of the techniques or other method-specific factors which influence the perfusion data for PET and CMR.…”

Section: Discussionsupporting

confidence: 89%

Inline perfusion mapping provides insights into the disease mechanism in hypertrophic cardiomyopathy

Camaioni

Knott

Augusto

et al. 2019

Heart

View full text Add to dashboard Cite

ObjectiveIn patients with hypertrophic cardiomyopathy (HCM), the role of small vessel disease and myocardial perfusion remains incompletely understood and data on absolute myocardial blood flow (MBF, mL/g/min) are scarce. We measured MBF using cardiovascular magnetic resonance fully quantitative perfusion mapping to determine the relationship between perfusion, hypertrophy and late gadolinium enhancement (LGE) in HCM.Methods101 patients with HCM with unobstructed epicardial coronary arteries and 30 controls (with matched cardiovascular risk factors) underwent pixel-wise perfusion mapping during adenosine stress and rest. Stress, rest MBF and the myocardial perfusion reserve (MPR, ratio of stress to rest) were calculated globally and segmentally and then associated with segmental wall thickness and LGE.ResultsIn HCM, 79% had a perfusion defect on clinical read. Stress MBF and MPR were reduced compared with controls (mean±SD 1.63±0.60 vs 2.30±0.64 mL/g/min, p<0.0001 and 2.21±0.87 vs 2.90±0.90, p=0.0003, respectively). Globally, stress MBF fell with increasing indexed left ventricle mass (R2 for the model 0.186, p=0.036) and segmentally with increasing wall thickness and LGE (both p<0.0001). In 21% of patients with HCM, MBF was lower during stress than rest (MPR <1) in at least one myocardial segment, a phenomenon which was predominantly subendocardial. Apparently normal HCM segments (normal wall thickness, no LGE) had reduced stress MBF and MPR compared with controls (mean±SD 1.88±0.81 mL/g/min vs 2.32±0.78 mL/g/min, p<0.0001).ConclusionsMicrovascular dysfunction is common in HCM and associated with hypertrophy and LGE. Perfusion can fall during vasodilator stress and is abnormal even in apparently normal myocardium suggesting it may be an early disease marker.

show abstract

Section: Discussionsupporting

confidence: 89%