Myocardial perfusion imaging after coronary artery bypass surgery using cardiovascular magnetic resonance: A validation study

Ranjit Arnold, Jane Francis, Theodoros Karamitsos, Chris Lim, William van Gaal, Luca Testa, Paul Bhamra-Ariza, Joseph Selvanayagam, Rana Sayeed, S Westaby, Adrian Banning, Stefan Neubauer, Michael Jerosch-Herold

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    5 Citations (Scopus)

    Abstract

    Background-Absolute quantification of perfusion with cardiovascular magnetic resonance has not previously been applied in patients with coronary artery bypass grafting (CABG). Owing to increased contrast bolus dispersion due to the greater distance of travel through a bypass graft, this approach may result in systematic underestimation of myocardial blood flow (MBF). As resting MBF remains normal in segments supplied by noncritical coronary stenosis (<85%), measurement of perfusion in such territories may be utilized to reveal systematic error in the quantification of MBF. The objective of this study was to test whether absolute quantification of perfusion with cardiovascular magnetic resonance systematically underestimates MBF in segments subtended by bypass grafts. Methods and Results-The study population comprised 28 patients undergoing elective CABG for treatment of multivessel coronary artery disease. Eligible patients had angiographic evidence of at least 1 myocardial segment subtended by a noncritically stenosed coronary artery (<85%). Subjects were studied at 1.5 T, with evaluation of resting MBF using model-independent deconvolution. Analyses were confined to myocardial segments subtended by native coronary arteries with<85% stenosis at baseline, and MBF was compared in grafted and ungrafted segments before and after revascularization. A total of 249 segments were subtended by coronary arteries with<85% stenosis at baseline. After revascularization, there was no significant difference in MBF in ungrafted (0.82±0.19 mL/min/g) versus grafted segments (0.82±0.15 mL/min/g, P=0.57). In the latter, MBF after revascularization did not change significantly from baseline (0.86±0.20 mL/min/g, P=0.82). Conclusions-Model-independent deconvolution analysis does not systematically underestimate blood flow in graft-subtended territories, justifying the use of this methodology to evaluate myocardial perfusion in patients with CABG.

    Original languageEnglish
    Pages (from-to)312-318
    Number of pages7
    JournalCirculation: Cardiovascular Imaging
    Volume4
    Issue number3
    DOIs
    Publication statusPublished - 1 May 2011

    Keywords

    • Cardiovascular imaging
    • Coronary artery bypass grafting
    • Myocardial blood flow

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