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Updated: Jun 10, 2025
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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
Published on: August 17, 2022
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Association between coronary microvascular dysfunction and exercise capacity in dilated cardiomyopathy
Abhishek Dattani1, Benjamin A Marrow1, Gaurav S Gulsin1
1Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK.
Summary
Dilated cardiomyopathy (DCM) patients show reduced myocardial perfusion reserve (MPR) and stress blood flow. MPR, left ventricular ejection fraction, and fibrosis are key factors linked to exercise capacity in DCM patients.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Exercise Physiology
Background:
- Aerobic exercise capacity predicts mortality in dilated cardiomyopathy (DCM).
- Mechanisms of exercise intolerance in DCM remain unclear.
- Coronary microvascular function in DCM requires characterization.
Purpose of the Study:
- To assess coronary microvascular function in DCM patients.
- To determine associations between cardiovascular magnetic resonance (CMR) measures and aerobic exercise capacity in DCM.
Main Methods:
- Prospective case-control study comparing DCM patients and matched controls.
- Adenosine-stress perfusion CMR for cardiac structure, function, and myocardial blood flow quantification.
- Cardiopulmonary exercise testing to measure peak VO2; multivariable regression analysis.
Main Results:
- DCM patients had significantly lower peak VO2 compared to controls.
- DCM group exhibited reduced stress myocardial blood flow and myocardial perfusion reserve (MPR).
- Left ventricular ejection fraction, extracellular volume fraction, and MPR independently correlated with peak VO2 in DCM.
Conclusions:
- DCM patients demonstrate impaired stress myocardial blood flow and MPR.
- MPR, LV ejection fraction, and fibrosis are independent predictors of aerobic exercise capacity in DCM.
Keywords:
Cardiovascular magnetic resonanceDilated cardiomyopathyExercise capacityMyocardial perfusion reserveMore Related Videos
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