023 Myocardial perfusion reserve falls in diabetes and with increasing age – a perfusion mapping study

Abstract

Objectives Myocardial perfusion reserve (MPR) is the ratio of myocardial blood flow (MBF) at stress to rest. A reduced MPR has been associated with a poor prognosis in quantitative Positron Emission Tomography studies. A likely mechanism is microvascular disease. Patients with diabetes mellitus often have microvascular disease and may have reduced MPR. We used automated in-line perfusion mapping, to quantify MBF at a pixel level in order to assess the MPR in patients with diabetes and other patients referred for clinical perfusion CMR. Method Over 7 months, stress perfusion CMR with perfusion mapping was performed on 1201 clinically referred patients. Of these, we identified 121 who had also had angiography (invasive or CT) within 6 months (mean 6.4 weeks). Patients with unobstructed epicardial coronary arteries ( Results Global LV MPR was: 3.07 across all patients, 2.33 for those with diabetes and 3.27 in those without diabetes (p=0.009). Multivariable analysis indicated that diabetes and age were negatively associated with MPR even after adjustment for sex, BSA, LGE, hypertension, LV EF and EDV (p Conclusion In patients with non-obstructive epicardial coronary artery disease, the myocardial perfusion reserve falls with diabetes and increasing age. This is immediately visualisable by used automated in-line perfusion mapping.