PMID- 27459149
OWN - NLM
STAT- MEDLINE
DCOM- 20170327
LR  - 20210109
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 39
IP  - 10
DP  - 2016 Oct
TI  - Stress Cardiac MRI in Women With Myocardial Infarction and Nonobstructive 
      Coronary Artery Disease.
PG  - 596-602
LID - 10.1002/clc.22571 [doi]
AB  - BACKGROUND: In a prospective study, cardiac MRI (CMR) and intravascular 
      ultrasound were performed in women with myocardial infarction (MI) and 
      nonobstructive coronary artery disease (MINOCA). Forty participants underwent 
      adenosine-stress CMR (sCMR). HYPOTHESIS: Abnormal perfusion may co-localize with 
      ischemic late gadolinium enhancement (LGE) and T2-weighted signal hyperintensity 
      (T2+), suggesting microvascular dysfunction contributed to MI. METHODS: 
      Qualitative perfusion analysis was performed by 2 independent readers. Abnormal 
      myocardial perfusion reserve index (MPRI) was defined as global average </=1.84. 
      RESULTS: Abnormal rest perfusion was present in 10 patients (25%) and stress 
      perfusion abnormalities in 25 (63%). Abnormal stress perfusion was not associated 
      with LGE but tended to occur with T2+. Among patients with abnormal perfusion and 
      LGE, the LGE pattern was ischemic in half. The locations of abnormal perfusion 
      and LGE matched in 75%, T2+ in 100%. Abnormal stress perfusion was not associated 
      with plaque disruption and matched in location in 63%. MPRI was abnormal in 10 
      patients (25%) and was not associated with LGE, T2+ or plaque disruption. 
      CONCLUSIONS: Abnormal perfusion on sCMR is common among women with MINOCA. 
      Abnormal perfusion usually co-localized with LGE and/or T2+ when present. 
      Variability in LGE pattern leads to uncertainty about whether the finding of 
      abnormal perfusion was cause or consequence of the tissue state leading to LGE. 
      Low MPRI, possibly indicating diffuse microvascular disease, was observed with 
      and without LGE and T2+. Multiple mechanisms may lead to abnormal perfusion on 
      sCMR. Microvascular dysfunction may contribute to the pathogenesis of and coexist 
      with other causes of MINOCA.
CI  - (c) 2016 Wiley Periodicals, Inc.
FAU - Mauricio, Rina
AU  - Mauricio R
AD  - Department of Medicine, New York University School of Medicine, New York, New 
      York.
FAU - Srichai, Monvadi B
AU  - Srichai MB
AD  - Department of Medicine, Georgetown University School of Medicine, Washington, DC.
FAU - Axel, Leon
AU  - Axel L
AD  - Department of Radiology, New York University School of Medicine, New York, New 
      York.
FAU - Hochman, Judith S
AU  - Hochman JS
AD  - Department of Medicine, New York University School of Medicine, New York, New 
      York.
FAU - Reynolds, Harmony R
AU  - Reynolds HR
AD  - Department of Medicine, New York University School of Medicine, New York, New 
      York. harmony.reynolds@NYUMC.org.
LA  - eng
PT  - Journal Article
DEP - 20160726
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Contrast Media)
RN  - 0 (Vasodilator Agents)
RN  - K72T3FS567 (Adenosine)
SB  - IM
MH  - Adenosine/*administration & dosage
MH  - Adult
MH  - Aged
MH  - Contrast Media/administration & dosage
MH  - Coronary Artery Disease/*diagnostic imaging/physiopathology
MH  - Coronary Circulation
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Microcirculation
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnostic imaging/physiopathology
MH  - Myocardial Perfusion Imaging/*methods
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Ultrasonography, Interventional
MH  - Vasodilator Agents/*administration & dosage
PMC - PMC6490801
OTO - NOTNLM
OT  - Ischemic heart disease
OT  - Women
OT  - mri
OT  - myocardial infarction
EDAT- 2016/10/28 06:00
MHDA- 2017/03/28 06:00
PMCR- 2016/07/26
CRDT- 2016/07/27 06:00
PHST- 2016/01/11 00:00 [received]
PHST- 2016/05/05 00:00 [revised]
PHST- 2016/06/06 00:00 [accepted]
PHST- 2016/10/28 06:00 [pubmed]
PHST- 2017/03/28 06:00 [medline]
PHST- 2016/07/27 06:00 [entrez]
PHST- 2016/07/26 00:00 [pmc-release]
AID - CLC22571 [pii]
AID - 10.1002/clc.22571 [doi]
PST - ppublish
SO  - Clin Cardiol. 2016 Oct;39(10):596-602. doi: 10.1002/clc.22571. Epub 2016 Jul 26.