Document Detail


Myocardial perfusion imaging after coronary artery bypass surgery using cardiovascular magnetic resonance: a validation study.
MedLine Citation:
PMID:  21343329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J Ranjit Arnold; Jane M Francis; Theodoros D Karamitsos; Chris C Lim; William J van Gaal; Luca Testa; Paul Bhamra-Ariza; Joseph B Selvanayagam; Rana Sayeed; Stephen Westaby; Adrian P Banning; Stefan Neubauer; Michael Jerosch-Herold
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2011-02-22
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  4     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-18     Completed Date:  2011-08-17     Revised Date:  2011-09-06    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  312-8     Citation Subset:  IM    
Affiliation:
University of Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Contrast Media
Coronary Angiography
Coronary Artery Bypass*
Coronary Artery Disease / physiopathology,  surgery*
Coronary Circulation*
Coronary Stenosis / diagnosis
Gadolinium DTPA / diagnostic use*
Humans
Magnetic Resonance Imaging*
Myocardial Perfusion Imaging*
Grant Support
ID/Acronym/Agency:
//British Heart Foundation; //Medical Research Council
Chemical
Reg. No./Substance:
0/Contrast Media; 122795-43-1/gadodiamide; 80529-93-7/Gadolinium DTPA

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