BOLD cardiovascular magnetic resonance at 3.0 tesla in myocardial ischemia.
BACKGROUND
The purpose of this study was to determine the ability of blood oxygen level dependent (BOLD) cardiovascular magnetic resonance (CMR) to detect stress-inducible myocardial ischemic reactions in the presence of angiographically significant coronary artery disease (CAD).


METHODS
Forty-six patients (34 men; age 65 ± 9 years,) with suspected or known coronary artery disease underwent CMR at 3Tesla prior to clinically indicated invasive coronary angiography. BOLD CMR was performed in 3 short axis slices of the heart at rest and during adenosine stress (140 μg/kg/min) followed by late gadolinium enhancement (LGE) imaging. In all 16 standard myocardial segments, T2* values were derived at rest and under adenosine stress. Quantitative coronary angiography served as the standard of reference and defined normal myocardial segments (i.e. all 16 segments in patients without any CAD), ischemic segments (i.e. supplied by a coronary artery with ≥50% luminal narrowing) and non-ischemic segments (i.e. supplied by a non-significantly stenosed coronary artery in patients with significant CAD).


RESULTS
Coronary angiography demonstrated significant CAD in 23 patients. BOLD CMR at rest revealed significantly lower T2* values for ischemic segments (26.7 ± 11.6 ms) compared to normal (31.9 ± 11.9 ms; p < 0.0001) and non-ischemic segments (31.2 ± 12.2 ms; p = 0.0003). Under adenosine stress T2* values increased significantly in normal segments only (37.2 ± 14.7 ms; p < 0.0001).


CONCLUSIONS
Rest and stress BOLD CMR at 3Tesla proved feasible and differentiated between ischemic, non-ischemic, and normal myocardial segments in a clinical patient population. BOLD CMR during vasodilator stress identified patients with significant CAD.
Manka
Robert
R
Department of Internal Medicine/Cardiology, German Heart Institute, Berlin, Germany. cjahnke@ukaachen.de
Paetsch
Ingo
I
Schnackenburg
Bernhard
B
Gebker
Rolf
R
Fleck
Eckart
E
Jahnke
Cosima
C
D000241:Adenosine; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D019786:Gadolinium DTPA; D005858:Germany; D006439:Hemodynamics; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014665:Vasodilator Agents
D015415:Biomarkers; D003287:Contrast Media; D014665:Vasodilator Agents; D019786:Gadolinium DTPA; D000241:Adenosine; D010100:Oxygen