Related Experiment Video

Updated: Jun 5, 2026

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
08:35

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

Published on: August 17, 2022

Opportunistic CT Attenuation Biomarkers of Anemia Are Associated With Impaired Myocardial Flow Reserve and

Robert J H Miller1,2, Aakash Shanbhag1,3, Jirong Yi1

  • 1Artificial Intelligence in Medicine Research Center, Departments of Biomedical Sciences, Medicine, and Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.

Medrxiv : the Preprint Server for Health Sciences
|June 4, 2026
PubMed

Insights

Anemia, detected via cardiac chamber density on CT scans, is linked to poorer heart function and increased cardiovascular event risk. This non-invasive imaging marker offers new insights for patient care.

Area of Science:

  • Cardiology
  • Radiology
  • Artificial Intelligence

Background:

  • Anemia is a known indicator of cardiovascular disease severity and risk.
  • Anemia can lead to elevated resting myocardial blood flow (MBF) and impaired myocardial flow reserve (MFR).
  • Cardiac chamber density changes on computed tomography (CT) may offer an opportunistic method for anemia detection.

Purpose of the Study:

  • To evaluate the relationship between cardiac chamber density measurements, hemoglobin levels, positron emission tomography (PET) findings, and cardiovascular events.
  • To assess the association of myocardial density with MFR and the risk of death or myocardial infarction (MI).

Main Methods:

  • A deep learning model was used to segment cardiac chambers and quantify chamber density from CT images.
  • Data from 57,828 patients across two large multicenter studies (REFINE-PET and lung cancer screening CT) were analyzed.
  • Relationships between chamber density, MBF, MFR, and cardiovascular outcomes (death, MI) were evaluated.

Main Results:

  • Higher myocardial density compared to left ventricle blood pool density was associated with reduced MFR (aOR 3.02) and increased risk of death or MI (aHR 1.38).
  • Increased myocardial density was also linked to cardiovascular death in patients undergoing low-dose chest CT (aHR 1.73).

Conclusions:

  • Lower cardiac chamber density is associated with impaired MFR and independently predicts cardiovascular events.
  • CT-derived cardiac chamber density serves as a potential non-invasive biomarker for anemia, offering physiological insights to guide patient management.
Abstract

Keywords:
AnemiaCTartificial intelligencedeep learningnuclear cardiology

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