Author + information
- Received March 5, 2010
- Revision received June 29, 2011
- Accepted June 30, 2011
- Published online December 1, 2011.
- Zungho Zun, PhD⁎,
- Padmini Varadarajan, MD†,
- Ramdas G. Pai, MD†,
- Eric C. Wong, MD, PhD‡ and
- Krishna S. Nayak, PhD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Krishna S. Nayak, 3740 McClintock Avenue, EEB 406, University of Southern California, Los Angeles, California 90089-2564
Objectives This study sought to determine whether arterial spin labeled (ASL) cardiac magnetic resonance (CMR) is capable of detecting clinically relevant increases in regional myocardial blood flow (MBF) with vasodilator stress testing in human myocardium.
Background Measurements of regional myocardial perfusion at rest and during vasodilatation are used to determine perfusion reserve, which indicates the presence and distribution of myocardial ischemia. ASL CMR is a perfusion imaging technique that does not require any contrast agents, and is therefore safe for use in patients with end-stage renal disease, and capable of repeated or continuous measurement.
Methods Myocardial ASL scans at rest and during adenosine infusion were incorporated into a routine CMR adenosine induced vasodilator stress protocol and was performed in 29 patients. Patients who were suspected of having ischemic heart disease based on first-pass imaging also underwent x-ray angiography. Myocardial ASL was performed using double-gated flow-sensitive alternating inversion recovery tagging and balanced steady-state free precession imaging at 3-T.
Results Sixteen patients were found to be normal and 13 patients were found to have visible perfusion defect based on first-pass CMR using intravenous gadolinium chelate. In the normal subjects, there was a statistically significant difference between MBF measured by ASL during adenosine infusion (3.67 ± 1.36 ml/g/min), compared to at rest (0.97 ± 0.64 ml/g/min), with p < 0.0001. There was also a statistically significant difference in perfusion reserve (MBFstress/MBFrest) between normal myocardial segments (3.18 ± 1.54) and the most ischemic segments in the patients with coronary artery disease identified by x-ray angiography (1.44 ± 0.97), with p = 0.0011.
Conclusions This study indicates that myocardial ASL is capable of detecting clinically relevant increases in MBF with vasodilatation and has the potential to identify myocardial ischemia.
Dr. Wong has received research support from G.E. Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 5, 2010.
- Revision received June 29, 2011.
- Accepted June 30, 2011.
- American College of Cardiology Foundation