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MR-based coronary artery blood velocity measurements in patients without coronary artery disease
M Schiemann1, F Bakhtiary, V Hietschold
1Institute of Diagnostic and Interventional Radiology University Hospital, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
Insights
Magnetic resonance-based coronary blood velocity measurements (MRvenc) are feasible for quantifying blood flow in coronary arteries. This technique shows potential for monitoring patients post-aortic valve surgery and detecting asymptomatic coronary artery disease (CAD).
Area of Science:
- Cardiovascular Imaging
- Medical Physics
Background:
- Coronary artery disease (CAD) diagnosis often relies on invasive procedures.
- Non-invasive methods for assessing coronary blood flow are crucial for early detection and monitoring.
- Magnetic resonance imaging (MRI) offers a non-invasive approach to visualize and quantify cardiovascular parameters.
Purpose of the Study:
- To assess the feasibility of MR-based coronary blood velocity measurements (MRvenc) in patients without obstructive coronary artery disease (CAD).
- To quantify systolic and diastolic blood velocities in the coronary arteries (CAs) using MRvenc.
- To explore potential clinical applications of MRvenc in cardiovascular patient management.
Main Methods:
- Eighty-three patients with angiographically excluded CAD underwent MRvenc of proximal coronary arteries.
- A retrospectively ECG-gated, breath-hold, phase-contrast FLASH sequence with high temporal resolution was employed.
- Blood velocity quantification and analysis of velocity profiles in systole and diastole were performed for left and right coronary arteries (LCA and RCA).
Main Results:
- Flow data were technically acquirable in 83% (137/166) of CAs.
- Biphasic velocity profiles, indicative of normal flow, were observed in 83% of analyzed CAs.
- Significant differences in median systolic and diastolic velocities were found in both LCA and RCA (P<0.0001 and P<0.01, respectively).
- The diastolic/systolic velocity ratio was 1.3 for LCA and 1.1 for RCA.
- Monophasic or altered velocity profiles were noted in the remaining CAs.
Conclusions:
- Optimized clinical MRvenc is a feasible technique for quantifying coronary artery blood velocities non-invasively.
- MRvenc holds potential for monitoring patients after aortic valve reconstruction.
- MRvenc may aid in the detection of asymptomatic CAD patients, enabling earlier intervention.
Abstract:
To evaluate the feasibility of MR-based coronary blood velocity measurements (MRvenc) in patients without coronary artery disease (CAD). Eighty-three patients with angiographically excluded CAD received MRvenc of the proximal segments of both coronary arteries (CAs). Using a retrospectively ECG-gated breath-hold phase-contrast FLASH sequence with high temporal resolution, flow data were technically acquirable in 137/166 (83%) CAs. Quantification and analysis of blood velocities in systole and diastole of both CAs were performed. Biphasic velocity profiles were found in 83/100 CAs. Median systolic and diastolic velocities differed significantly in LCA (19 cm/s, 24 cm/s; P<0.0001) and RCAs (14 cm/s, 16 cm/s; P<0.01). The diastolic/systolic velocity ratio was calculated in LCAs and RCAs with a median of 1.3 and 1.1, respectively. The velocity profiles of the remaining CAs were monophasic (17 CAs) or revealed severe alterations of the physiologic velocity profile with reduced flow undulations and steady velocities (37 CAs). Optimized clinical MRvenc is feasible to quantify blood velocities in the CAs. Potential indications are (1) non-invasive monitoring of patients after aortic valve reconstruction as well as (2) detection of asymptomatic CAD patients.
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