title: Feasibility of high-resolution quantitative perfusion analysis in patients with heart failure.
abstract: BACKGROUND
  Cardiac magnetic resonance (CMR) is playing an expanding role in the assessment of patients with heart failure (HF). The assessment of myocardial perfusion status in HF can be challenging due to left ventricular (LV) remodelling and wall thinning, coexistent scar and respiratory artefacts. The aim of this study was to assess the feasibility of quantitative CMR myocardial perfusion analysis in patients with HF.
  
  
  METHODS
  A group of 58 patients with heart failure (HF; left ventricular ejection fraction, LVEF ≤ 50%) and 33 patients with normal LVEF (LVEF >50%), referred for suspected coronary artery disease, were studied. All subjects underwent quantitative first-pass stress perfusion imaging using adenosine according to standard acquisition protocols. The feasibility of quantitative perfusion analysis was then assessed using high-resolution, 3 T kt perfusion and voxel-wise Fermi deconvolution.
  
  
  RESULTS
  30/58 (52%) subjects in the HF group had underlying ischaemic aetiology. Perfusion abnormalities were seen amongst patients with ischaemic HF and patients with normal LV function. No regional perfusion defect was observed in the non-ischaemic HF group. Good agreement was found between visual and quantitative analysis across all groups. Absolute stress perfusion rate, myocardial perfusion reserve (MPR) and endocardial-epicardial MPR ratio identified areas with abnormal perfusion in the ischaemic HF group (p = 0.02; p = 0.04; p = 0.02, respectively). In the Normal LV group, MPR and endocardial-epicardial MPR ratio were able to distinguish between normal and abnormal segments (p = 0.04; p = 0.02 respectively). No significant differences of absolute stress perfusion rate or MPR were observed comparing visually normal segments amongst groups.
  
  
  CONCLUSIONS
  Our results demonstrate the feasibility of high-resolution voxel-wise perfusion assessment in patients with HF.
authors.affiliation: King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, London, UK. eva.sammut@kcl.ac.uk.|Division of Imaging Sciences and Biomedical Engineering, King's College London, 4th Floor North Wing, St Thomas' Hospital, SE1 7EH, London, UK. eva.sammut@kcl.ac.uk.
authors.forename: Eva
authors.initials: E
authors.lastname: Sammut
authors.affiliation: King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, London, UK. niloufar.zarinabad@kcl.ac.uk.
authors.forename: Niloufar
authors.initials: N
authors.lastname: Zarinabad
authors.affiliation: King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, London, UK. roman.wesolowski@kcl.ac.uk.
authors.forename: Roman
authors.initials: R
authors.lastname: Wesolowski
authors.affiliation: King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, London, UK. geraint.morton@kcl.ac.uk.
authors.forename: Geraint
authors.initials: G
authors.lastname: Morton
authors.affiliation: King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, London, UK. zhong.chen@kcl.ac.uk.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Chen
authors.affiliation: King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, London, UK. manav.sohal@kcl.ac.uk.
authors.forename: Manav
authors.initials: M
authors.lastname: Sohal
authors.affiliation: Department of Cardiology, Guy's and St Thomas' Hospital, London, UK. gerry.carr-white@gstt.nhs.uk.
authors.forename: Gerry
authors.initials: G
authors.lastname: Carr-White
authors.affiliation: King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, London, UK. reza.razavi@kcl.ac.uk.
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.affiliation: King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, London, UK. amedeo.chiribiri@kcl.ac.uk.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Chiribiri
mesh_terms: D000328:Adult; D000368:Aged; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000503:physiopathology*; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left