PMID- 25160568
OWN - NLM
STAT- MEDLINE
DCOM- 20150330
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 16
IP  - 1
DP  - 2014 Aug 12
TI  - Coronary microvascular ischemia in hypertrophic cardiomyopathy - a pixel-wise 
      quantitative cardiovascular magnetic resonance perfusion study.
PG  - 49
LID - 10.1186/s12968-014-0049-1 [doi]
AB  - BACKGROUND: Microvascular dysfunction in HCM has been associated with adverse 
      clinical outcomes. Advances in quantitative cardiovascular magnetic resonance 
      (CMR) perfusion imaging now allow myocardial blood flow to be quantified at the 
      pixel level. We applied these techniques to investigate the spectrum of 
      microvascular dysfunction in hypertrophic cardiomyopathy (HCM) and to explore its 
      relationship with fibrosis and wall thickness. METHODS: CMR perfusion imaging was 
      undertaken during adenosine-induced hyperemia and again at rest in 35 patients 
      together with late gadolinium enhancement (LGE) imaging. Myocardial blood flow 
      (MBF) was quantified on a pixel-by-pixel basis from CMR perfusion images using a 
      Fermi-constrained deconvolution algorithm. Regions-of-interest (ROI) in 
      hypoperfused and hyperemic myocardium were identified from the MBF pixel maps. 
      The myocardium was also divided into 16 AHA segments. RESULTS: Resting MBF was 
      significantly higher in the endocardium than in the epicardium (mean +/- SD: 1.25 +/- 
      0.35 ml/g/min versus 1.20 +/- 0.35 ml/g/min, P<0.001), a pattern that reversed with 
      stress (2.00 +/- 0.76 ml/g/min versus 2.36 +/- 0.83 ml/g/min, P<0.001). ROI analysis 
      revealed 11 (31%) patients with stress MBF lower than resting values (1.05 +/- 0.39 
      ml/g/min versus 1.22 +/- 0.36 ml/g/min, P=0.021). There was a significant negative 
      association between hyperemic MBF and wall thickness (beta=-0.047 ml/g/min per mm, 
      95% CI: -0.057 to -0.038, P<0.001) and a significantly lower probability of 
      fibrosis in a segment with increasing hyperemic MBF (odds ratio per ml/g/min: 
      0.086, 95% CI: 0.078 to 0.095, P=0.003). CONCLUSIONS: Pixel-wise quantitative CMR 
      perfusion imaging identifies a subgroup of patients with HCM that have localised 
      severe microvascular dysfunction which may give rise to myocardial ischemia.
FAU - Ismail, Tevfik F
AU  - Ismail TF
FAU - Hsu, Li-Yueh
AU  - Hsu LY
FAU - Greve, Anders M
AU  - Greve AM
FAU - Goncalves, Carla
AU  - Goncalves C
FAU - Jabbour, Andrew
AU  - Jabbour A
FAU - Gulati, Ankur
AU  - Gulati A
FAU - Hewins, Benjamin
AU  - Hewins B
FAU - Mistry, Niraj
AU  - Mistry N
FAU - Wage, Ricardo
AU  - Wage R
FAU - Roughton, Michael
AU  - Roughton M
FAU - Ferreira, Pedro F
AU  - Ferreira PF
FAU - Gatehouse, Peter
AU  - Gatehouse P
FAU - Firmin, David
AU  - Firmin D
FAU - O'Hanlon, Rory
AU  - O'Hanlon R
FAU - Pennell, Dudley J
AU  - Pennell DJ
FAU - Prasad, Sanjay K
AU  - Prasad SK
FAU - Arai, Andrew E
AU  - Arai AE
LA  - eng
GR  - HL 006137-04/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20140812
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
RN  - 0 (Contrast Media)
RN  - 0 (Organometallic Compounds)
RN  - 0 (Vasodilator Agents)
RN  - 1BJ477IO2L (gadobutrol)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Algorithms
MH  - Cardiomyopathy, Hypertrophic/*diagnosis/pathology/physiopathology
MH  - Contrast Media
MH  - *Coronary Circulation
MH  - Coronary Vessels/*physiopathology
MH  - Female
MH  - Fibrosis
MH  - Humans
MH  - Hyperemia/physiopathology
MH  - Image Interpretation, Computer-Assisted
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - *Microcirculation
MH  - Microvessels/*physiopathology
MH  - Middle Aged
MH  - Myocardial Ischemia/*diagnosis/pathology/physiopathology
MH  - Myocardial Perfusion Imaging/*methods
MH  - Myocardium/pathology
MH  - Organometallic Compounds
MH  - Predictive Value of Tests
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Vasodilator Agents
PMC - PMC4145339
EDAT- 2014/08/28 06:00
MHDA- 2015/03/31 06:00
PMCR- 2014/08/12
CRDT- 2014/08/28 06:00
PHST- 2013/11/17 00:00 [received]
PHST- 2014/06/20 00:00 [accepted]
PHST- 2014/08/28 06:00 [entrez]
PHST- 2014/08/28 06:00 [pubmed]
PHST- 2015/03/31 06:00 [medline]
PHST- 2014/08/12 00:00 [pmc-release]
AID - S1097-6647(23)00116-3 [pii]
AID - s12968-014-0049-1 [pii]
AID - 10.1186/s12968-014-0049-1 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2014 Aug 12;16(1):49. doi: 10.1186/s12968-014-0049-1.