title: Cardiac magnetic resonance imaging for myocardial perfusion and diastolic function-reference control values for women.
abstract: Angina, heart failure with preserved ejection fraction (HFpEF) and coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease (CAD) are more common in women and are associated with adverse cardiovascular prognosis. Cardiac magnetic resonance imaging (CMRI) is established for assessment of left ventricular (LV) morphology and systolic function and is increasingly used to assess myocardial perfusion and diastolic function. Indeed, stress CMRI allows measurement of myocardial perfusion reserve index (MPRI) using semi-quantitative techniques, and quantification of LV volumetric filling patterns provides valuable insight into LV diastolic function. The utility of these two techniques remains limited, because reference control values for MPRI and LV diastolic function in asymptomatic middle-aged, women have not previously been established. To address this limitation, we recruited twenty women, without clinical cardiovascular disease or cardiovascular risk factors, with normal maximal Bruce protocol exercise treadmill testing. Subjects underwent CMRI (1.5 tesla) using a standardized protocol of adenosine stress and rest perfusion and LV cinematic imaging. Commercially available with automated CMRI segmentation was used for calculation of MPRI, LV filling profiles, and ejection fraction. Mean age was 54±9 years and mean body mass index was 25±4 kg/m(3). The exercise treadmill testing results demonstrated a normotensive group with normal functional capacity and hemodynamic response. We report reference control values for semi-quantitative MPRI as well as measures of LV systolic and diastolic function including ejection fraction, stroke volume, peak filling rate (PFR), PFR adjusted for end-diastolic volume (EDV) and stroke volume, time to PFR, and EDV index. The data herein provide reference values for MPRI and diastolic function in a cohort of healthy, middle-aged of women. These reference values may be used for comparison with a variety of patient populations, including women with CMD and HFpEF.
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: May
authors.initials: M
authors.lastname: Bakir
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Wei
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Nelson
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Puja K
authors.initials: PK
authors.lastname: Mehta
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Haftbaradaran
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Erika
authors.initials: E
authors.lastname: Jones
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Gill
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Behzad
authors.initials: B
authors.lastname: Sharif
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Debiao
authors.initials: D
authors.lastname: Li
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Chrisandra L
authors.initials: CL
authors.lastname: Shufelt
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Margo
authors.initials: M
authors.lastname: Minissian
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: C Noel
authors.initials: CN
authors.lastname: Bairey Merz
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, S. Mark Taper Foundation Imaging Center, Biomedical Imaging Research Institute Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Louise E J
authors.initials: LE
authors.lastname: Thomson
keywords: Women; diastolic function; magnetic resonance imaging (MRI); myocardial perfusion