Affiliation:
1. Department of Radiology The Second Xiangya Hospital, Central South University Changsha Hunan China
2. Department of Medical Imaging Affiliated Hospital of Jining Medical University Jining Shandong China
3. Department of Cardiology Affiliated Hospital of Jining Medical University Jining Shandong China
4. MR Application, Siemens Healthineers Ltd. Changsha China
5. MR Collaboration, Siemens Healthineers Ltd. Shanghai China
6. Circle Cardiovascular Imaging Inc. Calgary Alberta Canada
7. Department of Cardiovascular Medicine The Second Xiangya Hospital, Central South University Changsha China
Abstract
BackgroundIndicators for assessing myocardial viability and risk stratification in patients with coronary chronic total occlusion (CTO) are still in the research stage.PurposeTo use stress‐MRI to assess myocardial function, blood perfusion, and viability and to explore their relationship with collateral circulation.Study TypeProspective.SubjectsFifty‐one patients with CTO in at least one major artery confirmed by X‐ray coronary angiography (male: 46; age 55.2 ± 10.8 years).Field Strength/Sequence3.0T; TurboFlash, balanced steady‐state free precession cine, and phase‐sensitive inversion recovery sequences.AssessmentStress‐MRI was used to obtain qualitative and quantitative parameters of segmental myocardium. Myocardial segments supplied by CTO target vessels were grouped according to the degree of collateral circulation assessed by radiographic coronary angiography (no/mild, moderate, or good). Depending on qualitative stress perfusion assessment and late gadolinium enhancement (LGE) extent, segments were also categorized as negative, viable, or trans‐infarcted.Statistical TestsIndependent sample Student's t‐test, one‐way analysis of variance (ANOVA) test, Mann–Whitney U test, Kruskal–Wallis test, Spearman correlation coefficient (r). P < 0.05 was considered statistically significant.ResultsA total of 334 segments were supplied by CTO target vessels. The radial strain (RS), circumferential strain (CS), longitudinal strain (LS) of the negative, viable, and trans‐infarcted regions showed a significant and stepwise impairment. Myocardial blood flow at rest was positively correlated with RS, CS, and LS (r = 0.42, 0.43, 0.38, respectively). Among the different collateral circulation, there were no significant differences in RS, CS, LS, and LGE volume (P = 0.788, 0.562, 0.122, 0.170, respectively), and there were also no statistically significant differences in the proportions of negative, viable, and trans‐infarcted regions (P = 0.372).Data ConclusionMyocardial perfusion obtained by stress‐MRI combined with strain and LGE may comprehensively evaluate myocardial function and viability, and has potential to facilitate risk stratification of CTO.Evidence Level2Technical EfficacyStage 1
Funder
National Natural Science Foundation of China
Natural Science Foundation of Hunan Province
Subject
Radiology, Nuclear Medicine and imaging
Cited by
1 articles.
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