AIMS: Assessment of hyperaemia during adenosine stress cardiovascular magnetic resonance (CMR) remains a clinical challenge with lack of a gold-standard non-invasive clinical marker to confirm hyperaemic response. This study aimed to validate maximum stress myocardial blood flow (SMBF) measured using quantitative perfusion mapping for assessment of hyperaemic response and compare this to current clinical markers of adenosine stress. METHODS AND RESULTS: Two hundred and eighteen subjects underwent adenosine stress CMR. A derivation cohort (22 volunteers) was used to identify a SMBF threshold value for hyperaemia. This was tested in a validation cohort (37 patients with suspected coronary artery disease) who underwent invasive coronary physiology assessment on the same day as CMR. A clinical cohort (159 patients) was used to compare SMBF to other physiological markers of hyperaemia [splenic switch-off (SSO), heart rate response (HRR), and blood pressure (BP) fall]. A minimum SMBF threshold of 1.43 mL/g/min was derived from volunteer scans. All patients in the coronary physiology cohort demonstrated regional maximum SMBF (SMBFmax) >1.43 mL/g/min and invasive evidence of hyperaemia. Of the clinical cohort, 93% had hyperaemia defined by perfusion mapping compared to 71% using SSO and 81% using HRR. There was no difference in SMBFmax in those with or without SSO (2.58 ± 0.89 vs. 2.54 ± 1.04 mL/g/min, P = 0.84) but those with HRR had significantly higher SMBFmax (2.66 1.86 mL/g/min, P < 0.001). HRR >15 bpm was superior to SSO in predicting adequate increase in SMBF (AUC 0.87 vs. 0.62, P < 0.001). CONCLUSION: Adenosine-induced increase in myocardial blood flow is accurate for confirmation of hyperaemia during stress CMR studies and is superior to traditional, clinically used markers of adequate stress such as SSO and BP response. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Assessment of hyperaemia during adenosinestress cardiovascular magnetic resonance (CMR) remains a clinical challenge with lack of a gold-standard non-invasive clinical marker to confirm hyperaemic response. This study aimed to validate maximum stress myocardial blood flow (SMBF) measured using quantitative perfusion mapping for assessment of hyperaemic response and compare this to current clinical markers of adenosinestress. METHODS AND RESULTS: Two hundred and eighteen subjects underwent adenosinestress CMR. A derivation cohort (22 volunteers) was used to identify a SMBF threshold value for hyperaemia. This was tested in a validation cohort (37 patients with suspected coronary artery disease) who underwent invasive coronary physiology assessment on the same day as CMR. A clinical cohort (159 patients) was used to compare SMBF to other physiological markers of hyperaemia [splenic switch-off (SSO), heart rate response (HRR), and blood pressure (BP) fall]. A minimum SMBF threshold of 1.43 mL/g/min was derived from volunteer scans. All patients in the coronary physiology cohort demonstrated regional maximum SMBF (SMBFmax) >1.43 mL/g/min and invasive evidence of hyperaemia. Of the clinical cohort, 93% had hyperaemia defined by perfusion mapping compared to 71% using SSO and 81% using HRR. There was no difference in SMBFmax in those with or without SSO (2.58 ± 0.89 vs. 2.54 ± 1.04 mL/g/min, P = 0.84) but those with HRR had significantly higher SMBFmax (2.66 1.86 mL/g/min, P < 0.001). HRR >15 bpm was superior to SSO in predicting adequate increase in SMBF (AUC 0.87 vs. 0.62, P < 0.001). CONCLUSION:Adenosine-induced increase in myocardial blood flow is accurate for confirmation of hyperaemia during stress CMR studies and is superior to traditional, clinically used markers of adequate stress such as SSO and BP response. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Francesca Baessato; Marco Guglielmo; Giuseppe Muscogiuri; Andrea Baggiano; Laura Fusini; Stefano Scafuri; Mario Babbaro; Rocco Mollace; Ada Collevecchio; Andrea I Guaricci; Gianluca Pontone Journal: Biomed Res Int Date: 2021-01-14 Impact factor: 3.411
Authors: Andrea Baggiano; Gianpiero Italiano; Marco Guglielmo; Laura Fusini; Andrea Igoren Guaricci; Riccardo Maragna; Carlo Maria Giacari; Saima Mushtaq; Edoardo Conte; Andrea Daniele Annoni; Alberto Formenti; Maria Elisabetta Mancini; Daniele Andreini; Mark Rabbat; Mauro Pepi; Gianluca Pontone Journal: J Clin Med Date: 2022-01-18 Impact factor: 4.241
Authors: Amrit Chowdhary; Sharmaine Thirunavukarasu; Nicholas Jex; Lauren Coles; Charles Bowers; Anshuman Sengupta; Peter Swoboda; Klaus Witte; Richard Cubbon; Hui Xue; Peter Kellman; John Greenwood; Sven Plein; Eylem Levelt Journal: Obesity (Silver Spring) Date: 2022-03-31 Impact factor: 9.298