title: BOLD cardiovascular magnetic resonance at 3.0 tesla in myocardial ischemia.
abstract: 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.
authors.affiliation: Department of Internal Medicine/Cardiology, German Heart Institute, Berlin, Germany. cjahnke@ukaachen.de
authors.forename: Robert
authors.initials: R
authors.lastname: Manka
authors.forename: Ingo
authors.initials: I
authors.lastname: Paetsch
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schnackenburg
authors.forename: Rolf
authors.initials: R
authors.lastname: Gebker
authors.forename: Eckart
authors.initials: E
authors.lastname: Fleck
authors.forename: Cosima
authors.initials: C
authors.lastname: Jahnke
mesh_terms: 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
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D014665:Vasodilator Agents; D019786:Gadolinium DTPA; D000241:Adenosine; D010100:Oxygen