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Published on: February 16, 2016
Segmental evaluation of myocardial ischemia in stable coronary artery disease using native T1 mapping
Runlan Luo1, Qi''an Sun1, Yi Zhao1
1Department of Radiology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225001, China.
Insights
Native T1 mapping effectively visualizes myocardial ischemia in stable coronary artery disease (SCAD), identifying factors like number of diseased arteries and coronary artery calcium score that influence patient outcomes.
Area of Science:
- Cardiovascular Imaging
- Cardiac MRI
- Myocardial Perfusion
Background:
- Stable coronary artery disease (SCAD) requires accurate assessment of myocardial ischemia.
- Native T1 mapping in cardiac magnetic resonance (CMR) offers a non-invasive method to evaluate tissue characteristics.
Purpose of the Study:
- To assess myocardial ischemic segments in SCAD patients using native T1 mapping.
- To identify factors associated with myocardial ischemia in SCAD.
Main Methods:
- 316 SCAD patients and 30 controls underwent CMR native T1 mapping.
- Segmental native T1 values were analyzed using the AHA 16-segment model.
- Multivariable generalized estimating equations (GEE) identified independent factors for ischemia.
Main Results:
- Multi-vessel disease showed complex ischemia patterns, unlike single-vessel disease.
- Higher native T1 values were observed in anterior/anteroseptal segments with increased coronary artery stenosis.
- Diseased artery count, coronary artery calcium score, LAD-FFR, and culprit coronary artery were independent factors.
Conclusions:
- Native T1 mapping demonstrates heterogeneous myocardial ischemia in SCAD.
- This technique correlates with anatomical and functional parameters, aiding personalized SCAD management.
Objective:
To evaluate the myocardial ischemic segments and related factors in stable coronary artery disease (SCAD) patients by native T1 mapping.
Methods:
316 SCAD patients and 30 healthy controls (all right coronary dominant) underwent CMR native T1 mapping within 90 days of CCTA. Segmental native T1 values were measured using AHA 16-segment model. Patients were grouped by number of diseased coronary arteries (DCA [1-3]) with the largest diameter stenosis (DS [< or ≥ 50 %]) and culprit coronary artery (CCA [LAD, LCX, RCA]), or number of coronary artery stenosis ≥50 % (CAS [0-3]), respectively. Ischemic segments were defined as native T1 values significantly elevated versus controls. Multivariable generalized estimating equations (GEE) model was used to identify independent factors.
Results:
Single-vessel disease showed localized native T1 increases in corresponding perfusion territories, while multi-vessel disease exhibited complex ischemia patterns. Anterior and anteroseptal segments had significantly higher native T1 values in groups CAS 2 and 3 than CAS 0 and 1 (Bonferroni-adjusted P < 0.05). GEE model identified DCA (two-vessel disease: β = 13.6 ms, P = 0.010), CAS (1-3: β = 10.5, 34.4 and 57.2 ms, P < 0.05, respectively), and coronary artery calcium (CAC) score 3 and 4 (β = 12.2 and 14.5 ms, P < 0.05), LAD-fractional flow reserves (LAD-FFR) (β = -47.3 ms, P = 0.010) and CCA (LCX: β = -9.5 ms, P = 0.019) as independent factors.
Conclusion:
Native T1 mapping reveals spatially heterogenous ischemia in SCAD and is independently associated with both anatomical and functional parameters, supporting its value in personalized evaluation and management.
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