Myocardial flow reserve parametric map, assessed by first-pass MRI compartmental analysis at the chronic stage of infarction.
Regional myocardial flow and flow reserve (MFR) were assessed by compartmental analysis of Gd-enhanced MRI first-pass data in 7 patients with atypical chest pain, and in 15 patients with previous transmural myocardial infarction. The FE product (Flow x Extraction coefficient), derived from the modified Kety equation, was measured in regions corresponding to the Tetrofosmine-SPECT fixed defect and in remote normal regions. The FE product at rest and hyperemic FE product were similar in healed revascularized tissues (70.5 +/- 15.6 and 112.5 +/- 19.5 ml/mn/100 g, respectively) and in normal myocardium (76.2 +/- 18.3 and 142.2 +/- 33.0, respectively). In contrast, the FE index (48.8 +/- 15.2 and 60.7 +/- 18.0, respectively, P < 0.01 versus the two previous groups) and the MFR (1.27 +/- 0.20 vs. 1.91 +/- 0.29 in normal regions) were reduced in healed fibrotic tissues when the infarct-related artery remained occluded. Myocardial flow reserve maps allowed correct identification of regions corresponding to an occluded infarct-related artery.
Service de Cardiologie, Hôpital de Hautepierre, 67098 Strasbourg-France. baruthio@ipb.u-strasbg.fr
P
P
Germain
G
G
Roul
J
J
Baruthio
C
C
Jahn
P M
PM
Coulbois
B
B
Dumitresco
J L
JL
Dietemann
P
P
Bareiss
A
A
Constantinesco
D000368:Aged; D003097:Collateral Circulation / Q000502:physiology; D003326:Coronary Circulation / Q000502:physiology*; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis / Q000503:physiopathology; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon; D014945:Wound Healing / Q000502:physiology
D004176:Dipyridamole