Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonance
Background: Stress perfusion cardiovascular magnetic resonance (CMR) in the presence of atrial fibrillation (AF) has long been challenging due to electrocardiogram (ECG) mis-triggering. However, non-invasive ischemia imaging is important due to an increased risk of myocardial infarction in patients...
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Elsevier
2025-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664725000791 |
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| author | Richard J. Crawley Karl-Philipp Kunze Anmol Kaushal Xenios Milidonis Jack Highton Blanca Domenech-Ximenos Irum D. Kotadia Can Karamanli Nathan C.K. Wong Robbie Murphy Ebraham Alskaf Radhouene Neji Mark O’Neill Steven E. Williams Cian M. Scannell Sven Plein Amedeo Chiribiri |
| author_facet | Richard J. Crawley Karl-Philipp Kunze Anmol Kaushal Xenios Milidonis Jack Highton Blanca Domenech-Ximenos Irum D. Kotadia Can Karamanli Nathan C.K. Wong Robbie Murphy Ebraham Alskaf Radhouene Neji Mark O’Neill Steven E. Williams Cian M. Scannell Sven Plein Amedeo Chiribiri |
| author_sort | Richard J. Crawley |
| collection | DOAJ |
| description | Background: Stress perfusion cardiovascular magnetic resonance (CMR) in the presence of atrial fibrillation (AF) has long been challenging due to electrocardiogram (ECG) mis-triggering. However, non-invasive ischemia imaging is important due to an increased risk of myocardial infarction in patients with AF, which has been attributed to underlying microvascular dysfunction. Myocardial blood flow (MBF) in patients with AF is poorly understood, and few studies have attempted to quantify this through non-invasive imaging. Methods: Patients were recruited for stress perfusion CMR using a research sequence at 3-Tesla. Image acquisition occurred during both vasodilator-induced hyperemia and at rest. Stress and rest MBF maps were automatically generated. Analysis of perfusion maps included assessment of myocardial perfusion reserve (MPR) and endocardial-to-epicardial MBF ratios. Results: Around 442 patients were analyzed; 63 of whom had a history of AF and were in AF during the scan. Both MBF during hyperemia (stress MBF) and MPR were reduced in patients with AF compared to those in sinus rhythm (median stress MBF 1.85 [1.52–2.24] vs. 2.35 [1.98–2.77] mL/min/g, p<0.001; median MPR 1.95 [1.62–2.19] vs. 2.37 [2.05–2.80], p<0.001). No significant difference was seen between the two groups at rest (p=0.451). When considering co-factors affecting MBF, multivariate linear regression analysis identified the presence of AF as a significant independent contributor to stress MBF and MPR values. Both endocardial and epicardial stress MBF and MPR were reduced in AF compared with sinus rhythm (both p<0.001) and endocardial/epicardial ratios were similar between the groups. Conclusion: Automated quantitative MBF assessment can be performed in patients with AF. At hyperemia, MBF is reduced in AF compared to sinus rhythm. |
| format | Article |
| id | doaj-art-10b7cdadf05c48aca6fd3fd27552afde |
| institution | Kabale University |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-10b7cdadf05c48aca6fd3fd27552afde2025-08-20T03:50:58ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127210191710.1016/j.jocmr.2025.101917Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonanceRichard J. Crawley0Karl-Philipp Kunze1Anmol Kaushal2Xenios Milidonis3Jack Highton4Blanca Domenech-Ximenos5Irum D. Kotadia6Can Karamanli7Nathan C.K. Wong8Robbie Murphy9Ebraham Alskaf10Radhouene Neji11Mark O’Neill12Steven E. Williams13Cian M. Scannell14Sven Plein15Amedeo Chiribiri16School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom; Corresponding author.School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Magnetic Resonance Research Collaborations, Siemens Healthcare Limited, Camberley, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Guy’s and St Thomas’ NHS Foundation Trust, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; DeepCamera MRG, CYENS Centre of Excellence, Nicosia, CyprusSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Department of Medical Physics and Biomedical Engineering, University College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Department of Radiology, Hospital Clínic de Barcelona, Barcelona, SpainSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Guy’s and St Thomas’ NHS Foundation Trust, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Guy’s and St Thomas’ NHS Foundation Trust, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the NetherlandsSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom; Guy’s and St Thomas’ NHS Foundation Trust, London, United KingdomBackground: Stress perfusion cardiovascular magnetic resonance (CMR) in the presence of atrial fibrillation (AF) has long been challenging due to electrocardiogram (ECG) mis-triggering. However, non-invasive ischemia imaging is important due to an increased risk of myocardial infarction in patients with AF, which has been attributed to underlying microvascular dysfunction. Myocardial blood flow (MBF) in patients with AF is poorly understood, and few studies have attempted to quantify this through non-invasive imaging. Methods: Patients were recruited for stress perfusion CMR using a research sequence at 3-Tesla. Image acquisition occurred during both vasodilator-induced hyperemia and at rest. Stress and rest MBF maps were automatically generated. Analysis of perfusion maps included assessment of myocardial perfusion reserve (MPR) and endocardial-to-epicardial MBF ratios. Results: Around 442 patients were analyzed; 63 of whom had a history of AF and were in AF during the scan. Both MBF during hyperemia (stress MBF) and MPR were reduced in patients with AF compared to those in sinus rhythm (median stress MBF 1.85 [1.52–2.24] vs. 2.35 [1.98–2.77] mL/min/g, p<0.001; median MPR 1.95 [1.62–2.19] vs. 2.37 [2.05–2.80], p<0.001). No significant difference was seen between the two groups at rest (p=0.451). When considering co-factors affecting MBF, multivariate linear regression analysis identified the presence of AF as a significant independent contributor to stress MBF and MPR values. Both endocardial and epicardial stress MBF and MPR were reduced in AF compared with sinus rhythm (both p<0.001) and endocardial/epicardial ratios were similar between the groups. Conclusion: Automated quantitative MBF assessment can be performed in patients with AF. At hyperemia, MBF is reduced in AF compared to sinus rhythm.http://www.sciencedirect.com/science/article/pii/S1097664725000791PerfusionQuantitativeAtrial fibrillationMBF |
| spellingShingle | Richard J. Crawley Karl-Philipp Kunze Anmol Kaushal Xenios Milidonis Jack Highton Blanca Domenech-Ximenos Irum D. Kotadia Can Karamanli Nathan C.K. Wong Robbie Murphy Ebraham Alskaf Radhouene Neji Mark O’Neill Steven E. Williams Cian M. Scannell Sven Plein Amedeo Chiribiri Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonance Journal of Cardiovascular Magnetic Resonance Perfusion Quantitative Atrial fibrillation MBF |
| title | Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonance |
| title_full | Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonance |
| title_fullStr | Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonance |
| title_full_unstemmed | Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonance |
| title_short | Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonance |
| title_sort | measurement of myocardial blood flow in atrial fibrillation using high resolution free breathing in line quantitative cardiovascular magnetic resonance |
| topic | Perfusion Quantitative Atrial fibrillation MBF |
| url | http://www.sciencedirect.com/science/article/pii/S1097664725000791 |
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