Relationship between regional myocardial oxygenation and perfusion in patients with coronary artery disease insights from cardiovascular magnetic resonance and positron emission tomography

Theodoros D. Karamitsos, Lucia Leccisotti, Jayanth R. Arnold, Alejandro Recio-Mayoral, Paul Bhamra-Ariza, Ruairidh K. Howells, Nick Searle, Matthew D. Robson, Ornella E. Rimoldi, Paolo G. Camici, Stefan Neubauer, Joseph B. Selvanayagam

Research output: Contribution to journalArticlepeer-review

Abstract

Background-It is recognized that the interplay between myocardial ischemia, perfusion, and oxygenation in the setting of coronary artery disease (CAD) is complex and that myocardial oxygenation and perfusion may become dissociated. Blood oxygen level-dependent (BOLD) cardiovascular magnetic resonance (CMR) has the potential to noninvasively measure myocardial oxygenation, whereas positron emission tomography (PET) with oxygen-15 labeled water is the gold standard technique for myocardial blood flow quantification. Thus, we sought to apply BOLD CMR at 3 T and oxygen-15-labeled water PET in patients with CAD and normal volunteers to better understand the relationship between regional myocardial oxygenation and blood flow during vasodilator stress. Methods and Results-Twenty-two patients (age, 62±8 years; 16 men) with CAD (at least 1 stenosis ≥50% on quantitative coronary angiography) and 10 normal volunteers (age, 58±6 years; 6 men) underwent 3-T BOLD CMR and PET. For BOLD CMR, 4 to 6 midventricular short-axis images were acquired at rest and during adenosine stress (140 μg/kg/min). Using PET with oxygen-15-labeled water, myocardial blood flow was measured at baseline and during adenosine in the same slices. BOLD images were divided into 6 segments, and mean signal intensities calculated. Taking ≥50% stenosis on quantitative coronary angiography as the gold standard, cutoff values for stress myocardial blood flow (

Original languageEnglish
Pages (from-to)32-40
Number of pages9
JournalCirculation: Cardiovascular Imaging
Volume3
Issue number1
DOIs
Publication statusPublished - Jan 2010

Keywords

  • Blood-oxygen level dependent
  • Ischemia
  • Microvascular dysfunction
  • Myocardial blood flow

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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