Feasibility of cardiovascular magnetic resonance to detect oxygenation deficits in patients with multi-vessel coronary artery disease triggered by breathing maneuvers

• Verfasst von: Fischer, Kady [VerfasserIn]
• Verfasst von: Yamaji, Kyohei [VerfasserIn]
• Verfasst von: Luescher, Silvia [VerfasserIn]
• Verfasst von: Ueki, Yasushi [VerfasserIn]
• Verfasst von: Jung, Bernd [VerfasserIn]
• Verfasst von: von Tengg-Kobligk, Hendrik [VerfasserIn]
• Verfasst von: Windecker, Stephan [VerfasserIn]
• Verfasst von: Friedrich, Matthias [VerfasserIn]
• Verfasst von: Eberle, Balthasar [VerfasserIn]
• Verfasst von: Guensch, Dominik P. [VerfasserIn]
• Titel: Feasibility of cardiovascular magnetic resonance to detect oxygenation deficits in patients with multi-vessel coronary artery disease triggered by breathing maneuvers
• Verf.angabe: Kady Fischer, Kyohei Yamaji, Silvia Luescher, Yasushi Ueki, Bernd Jung, Hendrik von Tengg-Kobligk, Stephan Windecker, Matthias G. Friedrich, Balthasar Eberle and Dominik P. Guensch
• E-Jahr: 2018
• Jahr: 7 May 2018
• Umfang: 11 S.
• Fussnoten: Gesehen am 24.04.2020
• Titel Quelle: Enthalten in: Journal of cardiovascular magnetic resonance
• Ort Quelle: London : BioMed Central, 1999
• Jahr Quelle: 2018
• Band/Heft Quelle: 20(2018), Artikel-ID 31, Seite 1-11
• ISSN Quelle: 1532-429X
• DOI: doi:10.1186/s12968-018-0446-y
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aged
• Sach-SW: Biomarkers
• Sach-SW: BOLD
• Sach-SW: Breath Holding
• Sach-SW: Breathing maneuvers
• Sach-SW: Case-Control Studies
• Sach-SW: Coronary Angiography
• Sach-SW: Coronary artery disease
• Sach-SW: Coronary Artery Disease
• Sach-SW: Coronary Stenosis
• Sach-SW: Feasibility Studies
• Sach-SW: Female
• Sach-SW: Hemoglobins
• Sach-SW: Humans
• Sach-SW: Hypercapnia
• Sach-SW: Hyperventilation
• Sach-SW: Hypocapnia
• Sach-SW: Magnetic Resonance Imaging, Cine
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Myocardium
• Sach-SW: Oxygen
• Sach-SW: Oxygenation-sensitive cardiovascular magnetic resonance
• Sach-SW: Pilot Projects
• Sach-SW: Predictive Value of Tests
• Sach-SW: Respiratory Rate
• Sach-SW: Vasodilation
• K10plus-PPN: 169605382X

Abstract

BACKGROUND: Hyperventilation with a subsequent breath-hold has been successfully used as a non-pharmacological vasoactive stimulus to induce changes in myocardial oxygenation. The purpose of this pilot study was to assess if this maneuver is feasible in patients with multi-vessel coronary artery disease (CAD), and if it is effective at detecting coronary artery stenosis > 50% determined by quantitative coronary angiography (QCA). - METHODS: Twenty-six patients with coronary artery stenosis (QCA > 50% diameter stenosis) underwent a contrast-free cardiovascular magnetic resonance (CMR) exam in the time interval between their primary coronary angiography and a subsequent percutaneous coronary intervention (PCI, n = 24) or coronary artery bypass (CABG, n = 2) revascularization procedure. The CMR exam involved standard function imaging, myocardial strain analysis, T2 mapping, native T1 mapping and oxygenation-sensitive CMR (OS-CMR) imaging. During OS-CMR, participants performed a paced hyperventilation for 60s followed by a breath-hold to induce a vasoactive stimulus. Ten healthy subjects underwent the CMR protocol as the control group. - RESULTS: All CAD patients completed the breathing maneuvers with an average breath-hold duration of 48 ± 23 s following hyperventilation and without any complications or adverse effects. In comparison to healthy subjects, CAD patients had a significantly attenuated global myocardial oxygenation response to both hyperventilation (- 9.6 ± 6.8% vs. -3.1 ± 6.5%, p = 0.012) and apnea (11.3 ± 6.1% vs. 2.1 ± 4.4%, p < 0.001). The breath-hold maneuver unmasked regional oxygenation differences in territories subtended by a stenotic coronary artery in comparison to remote territory within the same patient (0.5 ± 3.8 vs. 3.8 ± 5.3%, p = 0.011). - CONCLUSION: Breathing maneuvers in conjunction with OS-CMR are clinically feasible in CAD patients. Furthermore, OS-CMR demonstrates myocardial oxygenation abnormalities in regional myocardium related to CAD without the use of pharmacologic vasodilators or contrast agents. A larger trial appears warranted for a better understanding of its diagnostic utility. - TRIAL REGISTRATION: Clinical Trials Identifier: NCT02233634 , registered 8 September 2014.