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Cardiac Magnetic Resonance-Derived Coronary Sinus Flow Reserve Can Accurately Determine Global Myocardial Perfusion
S190
Abstracts CSANZ 2012 Abstracts
ABSTRACTS
ship between fatigue and T1 post contrast time in obese women is intriguing, particularly as BMI is modifiable. http://dx.doi.org/10.1016/j.hlc.2012.05.470 460 Cardiac Magnetic Resonance, Transthoracic and Transoesophageal Echocardiography: A Comparison of In Vivo Ventricular Function Assessment in Rats
Heart, Lung and Circulation 2012;21:S143–S316
461 Cardiac Magnetic Resonance-Derived Coronary Sinus Flow Reserve Can Accurately Determine Global Myocardial Perfusion J. Richardson 1,2,∗ , A. Nelson 1,2 , A. Bertaso 1 , D. Wong 1,2 , M. Cunnington 1 , S. Azarisman 1,2 , H. Chua 1 , T. Baillie 1 , T. Glenie 1 , B. Koschade 1 , K. Williams 1 , K. Teo 1,2 , M. Worthley 1,2 , S. Worthley 1,2 1 Cardiovascular
J. Richardson 1,2,3,∗ , A. Bertaso 1 , B. Koschade 1 , D. Wong 1,2 , K. Williams 1 , L. Frost 1,2 , A. Carbone 1,2 , S. Paton 3 , A. Nelson 1,2 , P. Psaltis 1,2 , M. Worthley 1,2 , K. Teo 1,2 , S. Gronthos 3 , A. Zannettino 3 , S. Worthley 1,2,3
Research Centre, Royal Adelaide Hospital, Australia 2 Department of Medicine, University of Adelaide, Adelaide, SA, Australia
1 Cardiovascular
Background: Invasive coronary sinus flow reserve (CSFR) during vasodilator stress can be used as a surrogate for global myocardial perfusion. This can potentially be performed non-invasively with cardiac magnetic resonance imaging (CMR). We evaluated a CMR protocol for assessing CSFR during adenosine stress CMR imaging and compared it with a CMR assessment of myocardial perfusion reserve index (MPRI), acquired simultaneously. Methods: Patients referred for adenosine stress perfusion CMR were recruited (n = 12). An off-axis vertical long axis image was prescribed to perpendicularly bisect the CS 1 cm from its ostium. Velocity encoded flow images (20 phases, VENC 80 cm/s) were acquired after 3 min of adenosine (140 mcg/kg/min) infusion. This was immediately followed by perfusion imaging comprising a T1-weighted fast low-angle single shot gradient-echo sequence. Flow and perfusion imaging were repeated at rest >10 min later. Calculation of flow volume was performed off-line and CSFR was defined as stress/rest flow volume. Global MPRI was determined in a standard method. Results: All subjects had normal perfusion images as determined visually and on regional MPRI. Mean CSFR was 3.04 ± 0.32 and mean global MPRI was 3.37 ± 0.24. There was good correlation between paired measurements, with a Pearson r value = 0.78 and r2 = 0.60 (p < 0.01). Conclusion: CMR-derived CSFR shows good correlation with MPRI. This data suggests that CSFR might be a useful non-contrast, non-radiation alternative for the assessment of global myocardial perfusion.
Research Centre, Royal Adelaide Hospital, Australia 2 Department of Medicine, University of Adelaide, Adelaide, SA, Australia 3 Centre for Stem Cell Research, University of Adelaide, Adelaide, SA, Australia Background: Assessment of in vivo ventricular function is frequently undertaken in small animal models of cardiovascular disease. Transthoracic echocardiography (TTE) is most commonly utilised, but is operator-dependent and often reliant on M-mode imaging. Cardiac magnetic resonance (CMR) is the gold standard reference in large animals, but use in small animal studies is hindered by technological constraints previously only overcome with high field scanners. To date, no study has systematically assessed transoesophageal echo (TOE), TTE and 1.5T CMR analysis of ejection fraction (EF) in rodents. Methods: Twenty Sprague–Dawley rats underwent surgical ligation of the left anterior descending artery. Assessment of EF was performed at the same sitting, four weeks post-MI. CMR was performed on a 1.5T Siemens Sonata, in conjunction with a carotid receiver coil to generate ECG-gated cine images at three short axis slices. TTE was performed using a Siemens Acuson X300 ultrasound, in conjunction with a 9.2 MHz transducer, and derived a single mid-LV short axis slice. TOE was performed with a 10 MHz intra cardiac echo catheter providing a 2-chamber view. Correlation between the three techniques for EF determination and analysis reproducibility was evaluated using two blinded observers. Results: The greatest EF correlation was observed between CMR/TOE (intraclass correlation coefficient (ICC) = 0.885), followed by TOE/TTE (ICC = 0.725) and CMR/TTE (ICC = 0.664). Intra- and inter-observer variations were excellent with CMR (ICC = 0.99 and 0.98, respectively), very good with TOE (0.874 and 0.839) and mixed with TTE (0.898 and 0.30). Conclusion: 1.5T CMR and TOE are viable and reproducible technologies to evaluate ventricular function in rats. Good correlation of EF measurements was observed with all three modalities. Reproducibility of image analysis was excellent with CMR and TOE, but moderate with TTE. http://dx.doi.org/10.1016/j.hlc.2012.05.471
http://dx.doi.org/10.1016/j.hlc.2012.05.472 462 Cardiac MRI Predictors of Short-Term Outcomes After High Risk Coronary Artery Bypass Surgery M. Sheriff ∗ , O. Puranik
Mouline, M.
Vallely, M.
Wilson, R.
Royal Prince Alfred Hospital, Sydney, Australia Background and objective: Risk scoring pre-coronary artery graft surgery (CAGS; e.g. euroSCORE) may lack the specificity to accurately predict outcomes in high-risk patients (
Abstracts CSANZ 2012 Abstracts
ABSTRACTS
ship between fatigue and T1 post contrast time in obese women is intriguing, particularly as BMI is modifiable. http://dx.doi.org/10.1016/j.hlc.2012.05.470 460 Cardiac Magnetic Resonance, Transthoracic and Transoesophageal Echocardiography: A Comparison of In Vivo Ventricular Function Assessment in Rats
Heart, Lung and Circulation 2012;21:S143–S316
461 Cardiac Magnetic Resonance-Derived Coronary Sinus Flow Reserve Can Accurately Determine Global Myocardial Perfusion J. Richardson 1,2,∗ , A. Nelson 1,2 , A. Bertaso 1 , D. Wong 1,2 , M. Cunnington 1 , S. Azarisman 1,2 , H. Chua 1 , T. Baillie 1 , T. Glenie 1 , B. Koschade 1 , K. Williams 1 , K. Teo 1,2 , M. Worthley 1,2 , S. Worthley 1,2 1 Cardiovascular
J. Richardson 1,2,3,∗ , A. Bertaso 1 , B. Koschade 1 , D. Wong 1,2 , K. Williams 1 , L. Frost 1,2 , A. Carbone 1,2 , S. Paton 3 , A. Nelson 1,2 , P. Psaltis 1,2 , M. Worthley 1,2 , K. Teo 1,2 , S. Gronthos 3 , A. Zannettino 3 , S. Worthley 1,2,3
Research Centre, Royal Adelaide Hospital, Australia 2 Department of Medicine, University of Adelaide, Adelaide, SA, Australia
1 Cardiovascular
Background: Invasive coronary sinus flow reserve (CSFR) during vasodilator stress can be used as a surrogate for global myocardial perfusion. This can potentially be performed non-invasively with cardiac magnetic resonance imaging (CMR). We evaluated a CMR protocol for assessing CSFR during adenosine stress CMR imaging and compared it with a CMR assessment of myocardial perfusion reserve index (MPRI), acquired simultaneously. Methods: Patients referred for adenosine stress perfusion CMR were recruited (n = 12). An off-axis vertical long axis image was prescribed to perpendicularly bisect the CS 1 cm from its ostium. Velocity encoded flow images (20 phases, VENC 80 cm/s) were acquired after 3 min of adenosine (140 mcg/kg/min) infusion. This was immediately followed by perfusion imaging comprising a T1-weighted fast low-angle single shot gradient-echo sequence. Flow and perfusion imaging were repeated at rest >10 min later. Calculation of flow volume was performed off-line and CSFR was defined as stress/rest flow volume. Global MPRI was determined in a standard method. Results: All subjects had normal perfusion images as determined visually and on regional MPRI. Mean CSFR was 3.04 ± 0.32 and mean global MPRI was 3.37 ± 0.24. There was good correlation between paired measurements, with a Pearson r value = 0.78 and r2 = 0.60 (p < 0.01). Conclusion: CMR-derived CSFR shows good correlation with MPRI. This data suggests that CSFR might be a useful non-contrast, non-radiation alternative for the assessment of global myocardial perfusion.
Research Centre, Royal Adelaide Hospital, Australia 2 Department of Medicine, University of Adelaide, Adelaide, SA, Australia 3 Centre for Stem Cell Research, University of Adelaide, Adelaide, SA, Australia Background: Assessment of in vivo ventricular function is frequently undertaken in small animal models of cardiovascular disease. Transthoracic echocardiography (TTE) is most commonly utilised, but is operator-dependent and often reliant on M-mode imaging. Cardiac magnetic resonance (CMR) is the gold standard reference in large animals, but use in small animal studies is hindered by technological constraints previously only overcome with high field scanners. To date, no study has systematically assessed transoesophageal echo (TOE), TTE and 1.5T CMR analysis of ejection fraction (EF) in rodents. Methods: Twenty Sprague–Dawley rats underwent surgical ligation of the left anterior descending artery. Assessment of EF was performed at the same sitting, four weeks post-MI. CMR was performed on a 1.5T Siemens Sonata, in conjunction with a carotid receiver coil to generate ECG-gated cine images at three short axis slices. TTE was performed using a Siemens Acuson X300 ultrasound, in conjunction with a 9.2 MHz transducer, and derived a single mid-LV short axis slice. TOE was performed with a 10 MHz intra cardiac echo catheter providing a 2-chamber view. Correlation between the three techniques for EF determination and analysis reproducibility was evaluated using two blinded observers. Results: The greatest EF correlation was observed between CMR/TOE (intraclass correlation coefficient (ICC) = 0.885), followed by TOE/TTE (ICC = 0.725) and CMR/TTE (ICC = 0.664). Intra- and inter-observer variations were excellent with CMR (ICC = 0.99 and 0.98, respectively), very good with TOE (0.874 and 0.839) and mixed with TTE (0.898 and 0.30). Conclusion: 1.5T CMR and TOE are viable and reproducible technologies to evaluate ventricular function in rats. Good correlation of EF measurements was observed with all three modalities. Reproducibility of image analysis was excellent with CMR and TOE, but moderate with TTE. http://dx.doi.org/10.1016/j.hlc.2012.05.471
http://dx.doi.org/10.1016/j.hlc.2012.05.472 462 Cardiac MRI Predictors of Short-Term Outcomes After High Risk Coronary Artery Bypass Surgery M. Sheriff ∗ , O. Puranik
Mouline, M.
Vallely, M.
Wilson, R.
Royal Prince Alfred Hospital, Sydney, Australia Background and objective: Risk scoring pre-coronary artery graft surgery (CAGS; e.g. euroSCORE) may lack the specificity to accurately predict outcomes in high-risk patients (