Abstract
Increased endocardial to epicardial flow ratio present at rest disappears during exercise stress perfusion CMR in normal volunteers a potential mechanism for exercise induced subendocardial ischaemia Kaleab N Asrress, Rupert Williams, Tim Lockie, John D Biglands, Amedeo Chiribiri, Aleksandra Radjenovic, Roy Jogiya, Kalpa De Silva, Sebastian Kozerke, Phil Chowienczyk, Eike Nagel, Michael Marber, Simon Redwood, Sven Plein
Highlights
Exercise stress testing remains the most physiological method of inducing myocardial stress
Increased endocardial to epicardial flow ratio present at rest disappears during exercise stress perfusion CMR in normal volunteers - a potential mechanism for exercise induced subendocardial ischaemia
The feasibility of physiological stress in the MR environment have limited its clinical and scientific application, but MR compatible ergometers are available that permit measurement of the response to exercise-stress
Summary
Exercise stress testing remains the most physiological method of inducing myocardial stress. The feasibility of physiological stress in the MR environment have limited its clinical and scientific application, but MR compatible ergometers are available that permit measurement of the response to exercise-stress. An important mechanism governing inducible ischaemia is the redistribution of myocardial blood flow between the endocardial and epicardial layers. With high-resolution CMR methods, these responses can be measured providing a potential technique with which these parameters can be studied during physiological stress. The purpose of this study was to quantify absolute myocardial blood flow as well as endocardial and epicardial segmental flow during rest and exercise stress; and to demonstrate the reproducibility of these measurements under serial exercise
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