Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

• DOI: 10.1161/circimaging.111.969667
• Publication Date: 2012-02-09T01:31:49Z
• Authors: Theodoros D. Kara...; Jayanth R. Arnold; Tammy J. Pegg; Jane M. Francis; Jacqueline Birks; Michael Jerosch-H...; Stefan Neubauer; Joseph B. Selvana...
• Keywords: Gadolinium DTPA; Male; Adenosine; Chi-Square Distribution; Myocardium; Hemodynamics; Myocardial Perfusion Imaging; Contrast Media; Middle Aged; Magnetic Resonance Imaging; 3. Good health; 03 medical and health sciences; Oxygen Consumption; 0302 clinical medicine; England; Case-Control Studies; Coronary Circulation; Linear Models; Humans; Female; Aged; Microvascular Angina; Pain Measurement

Background— The pathophysiology of chest pain in patients with cardiac syndrome X remains controversial. Advances perfusion imaging cardiovascular magnetic resonance (CMR) now enable absolute quantification regional myocardial blood flow (MBF). Furthermore, oxygen level-dependent (BOLD) or oxygenation-sensitive CMR provides the unprecedented capability to assess oxygenation. We hypothesized that combined assessment and oxygenation could clarify whether show evidence ischemia (reduced oxygenation) during vasodilator stress compared normal volunteers. Methods Results— Eighteen (chest pain, abnormal exercise treadmill test, coronary angiogram without other causes microvascular dysfunction) 14 controls underwent scanning at 3 T. Myocardial function, scar, (2–3 short-axis slices), were assessed. Absolute MBF was measured adenosine (140 μg/kg per minute) rest by model-independent deconvolution. For oxygenation, using a T2-prepared BOLD sequence, signal intensity slice matched midventricular scan. There no significant differences (2.35 versus 2.37 mL/min gram; P =0.91), change (17.3% 17.09%; reserve measurements (2.63 2.53; =0.60) controls, respectively. Oxygenation territory also similar between 2 groups. More (17/18 [94%]) developed than (6/14 [43%]; =0.004). Conclusions— Patients greater sensitivity but deoxygenation hypoperfusion vasodilatory stress.