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Susceptibility-sensitive magnetic resonance imaging detects human myocardium supplied by a stenotic coronary artery without a contrast agent

C. Wacker, A. Hartlep, S. Pfleger, L. Schad, G. Ertl and W. Bauer

J Am Coll Cardiol, 41 (5), pp.834-840

OBJECTIVES: Evaluation of the severity of a coronary artery stenosis is of paramount importance for therapy. A relevant stenosis provokes post-stenotic microvascular dilation with capillary recruitment. This autoregulatory response was investigated in the present study by use of susceptibility-sensitive magnetic resonance imaging (MRI) without contrast agents. BACKGROUND: Functional alterations of the microvascular system may be studied noninvasively and without a contrast agent by susceptibility-sensitive MRI, which is based on the paramagnetic property of deoxyhemoglobin. This effect, also referred to as the "blood oxygenation level-dependent (BOLD) effect," is investigated by phase relaxation (T(2)*) measurements. METHODS: In patients (n = 16) with single-vessel coronary artery disease, no history of myocardial infarction, normal left ventricular function at rest, and a positive stress echocardiogram, the susceptibility-sensitive parameter T(2)* was assessed in the myocardium. RESULTS: In regions associated with the stenotic artery, T(2)* was significantly lower than in residual myocardium (p < 0.01). This difference in T(2)* increased after application of the vasodilator dipyridamole (p < 0.001). In patients being re-investigated after therapeutic interventions, the microvascular dilation was partly removed. CONCLUSIONS: For the first time, we could show that myocardial BOLD MRI detects post-stenotic capillary recruitment dependent on coronary artery stenosis.

Contact: Dr. Frank Zöllner last modified: 21.05.2019
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