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Updated: Aug 23, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
[Minimally invasive quantitation of myocardial microvascular function using computed tomography: the blood
S Möhlenkamp1, E L Ritman, M Haude
1Klinik für Kardiologie im Westdeutschen Herzzentrum Essen, Hufelandstrasse 55, 45122 Essen, Germany. stefan.moehlenkamp@uni-essen.de
Insights
A novel fast computed tomography method quantifies intramyocardial microvascular function by analyzing blood volume and flow relationships. This approach detects early coronary artery disease and other pathologies noninvasively.
Area of Science:
- Cardiology
- Medical Imaging
- Physiology
Background:
- Intramyocardial coronary microvasculature regulates myocardial perfusion.
- Microvascular dysfunction is implicated in early coronary artery disease, hypertrophy, cardiomyopathy, hypertension, and diabetes.
- Noninvasive assessment of microvascular function is crucial for diagnosing and managing cardiovascular diseases.
Purpose of the Study:
- To introduce and validate a novel noninvasive method for quantifying intramyocardial microvascular function.
- To demonstrate the sensitivity of the blood volume-to-flow relationship in characterizing microvascular pathologies.
- To explore the potential applications of this method in various cardiovascular conditions.
Main Methods:
- Utilized fast computed tomography (CT) for simultaneous noninvasive quantitation of regional intramyocardial blood volume and myocardial perfusion.
- Applied indicator dilution principles to analyze the blood volume-to-flow relationship.
- Evaluated the method in models of acute microembolization, chronic hypercholesterolemia, non-significant stenoses, and normal microvascular maturation.
Main Results:
- The blood volume-to-flow relationship effectively characterized and quantified the functional impact of pathologies on microvascular function.
- Demonstrated sensitivity in detecting acute microvascular impairment, endothelial dysfunction, and heterogeneity of microvascular function.
- Validated the method's ability to assess physiologic maturation of the normal microvasculature.
Conclusions:
- The blood volume-to-flow relationship derived from fast CT is a sensitive tool for noninvasive quantification of intramyocardial microvascular function.
- This approach can detect and characterize various microvascular pathologies relevant to cardiovascular diseases.
- The method holds promise as an adjunct to existing imaging techniques for comprehensive cardiovascular assessment.
Abstract:
The intramyocardial coronary microvasculature has an important role in regulating regional myocardial perfusion. Pathologic alterations of microvascular function may be present in early stages of coronary artery disease, myocardial hypertrophy, cardiomyopathy or systemic diseases such as arterial hypertension and diabetes mellitus. Fast computed tomography permits noninvasive simultaneous quantitation of regional intramyocardial blood volume and myocardial perfusion using indicator dilution principles. Our data indicate that especially the blood volume-to-flow relationship is sensitive enough to characterize and quantitate the functional impact of different pathologies along the coronary tree on microvascular function. This could be demonstrated for 1) acute impairment of microvascular function following coronary microembolization, 2) endothelial dysfunction induced by chronic hypercholesterolemia, 3) chronic epicardial non-significant stenoses, 4) physiologic maturation of the normal microvasculature and 5) quantification of heterogeneity of microvascular function. These findings, the methodological background and the concept itself are presented in this article. Application of the blood volume-to-flow relationship is not limited to fast-CT but may be used in any cross sectional imaging technique, such as MRI or echocardiography, as long as intramyocardial blood volume and perfusion can be quantitated simultaneously. This new noninvasive approach to the quantification of intramyocardial microvascular function may prove a useful adjunct to those imaging techniques that are used to noninvasively quantitate epicardial stenoses or regional wall motion abnormalities.
