Coronary Wall Thickness Research Articles

Feasibility of coronary artery wall thickening assessment in asymptomatic coronary artery disease using phase-sensitive dual-inversion recovery MRI at 3 T

ObjectivesThe purpose of this study was to (a) investigate the image quality of phase-sensitive dual-inversion recovery (PS-DIR) coronary wall imaging in healthy subjects and in subjects with known coronary artery disease (CAD) and to (b) investigate the utilization of PS-DIR at 3T in the assessment of coronary artery thickening in subjects with asymptomatic but variable degrees of CAD. Materials and MethodsA total of 37 subjects participated in this institutional review board-approved and HIPAA-compliant study. These included 21 subjects with known CAD as identified on multidetector computed tomography angiography (MDCT). Sixteen healthy subjects without known history of CAD were included. All subjects were scanned using free-breathing PS-DIR magnetic resonance imaging (MRI) for the assessment of coronary wall thickness at 3T. Lumen–tissue contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR) and quantitative vessel parameters including lumen area and wall thickness were measured. Statistical analyses were performed. ResultsPS-DIR was successfully completed in 76% of patients and in 88% of the healthy subjects. Phase-sensitive signed-magnitude reconstruction, compared to modulus-magnitude images, significantly improved lumen–tissue CNR in healthy subjects (26.73±11.95 vs. 14.65±9.57, P<.001) and in patients (21.45±7.61 vs. 16.65±5.85, P<.001). There was no difference in image CNR and SNR between groups. In arterial segments free of plaques, coronary wall was thicker in patients in comparison to healthy subjects (1.74±0.27mm vs. 1.17±0.14mm, P<.001), without a change in lumen area (4.51±2.42mm2 vs. 5.71±3.11mm2, P=.25). ConclusionsThis is the first study to demonstrate the feasibility of successfully obtaining vessel wall images at 3T using PS-DIR in asymptomatic patients with known variable degrees of CAD as detected by MDCT. This was achieved with a fixed subject-invariant planning of blood signal nulling. With that limitation alleviated, PS-DIR coronary wall MRI is capable of detecting arterial thickening and positive arterial remodeling at 3T in asymptomatic CAD.

Weekly Doxorubicin Increases Coronary Arteriolar Wall and Adventitial Thickness

BackgroundDoxorubicin (DOX) is associated with premature cardiovascular events including myocardial infarction. This study was performed to determine if the weekly administration of DOX influenced coronary arteriolar medial and/or adventitial wall thickening.MethodsThirty-two male Sprague-Dawley rats aged 25.1± 2.4 weeks were randomly divided into three groups and received weekly intraperitoneal injections of normal saline (saline, n = 7), or low (1.5 mg/kg to 1.75 mg/kg, n = 14) or high (2.5 mg/kg, n = 11) doses of DOX. The animals were treated for 2–12 weeks, and euthanized at pre-specified intervals (2, 4, 7, or 10+ weeks) to obtain histopathologic assessments of coronary arteriolar lumen diameter, medial wall thickness, adventitial wall thickness, and total wall thickness (medial thickness + adventitial thickness).ResultsLumen diameter was similar across all groups (saline: 315±34 µm, low DOX: 286±24 µm, high DOX: 242±27 µm; p = 0.22). In comparison to animals receiving weekly saline, animals receiving weekly injections of 2.5 mg/kg of DOX experienced an increase in medial (23±2µm vs. 13±3µm; p = 0.005), and total wall thickness (51±4µm vs. 36±5µm; p = 0.022), respectively. These increases, as well as adventitial thickening became more prominent after normalizing for lumen diameter (p<0.05 to p<0.001) and after adjusting for age, weight, and total cumulative DOX dose (p = 0.02 to p = 0.01). Animals receiving low dose DOX trended toward increases in adventitial and total wall thickness after normalization to lumen diameter and accounting for age, weight, and total cumulative DOX dose (p = 0.06 and 0.09, respectively).ConclusionIn conclusion, these data demonstrate that weekly treatment of rats with higher doses of DOX increases coronary arteriolar medial, adventitial, and total wall thickness. Future studies are warranted to determine if DOX related coronary arteriolar effects are reversible or preventable, exacerbate the known cardiomyopathic effects of DOX, influence altered resting or stress-induced myocardial perfusion, or contribute to the occurrence of myocardial infarction.

Potential Quantitative Magnetic Resonance Imaging Biomarkers of Coronary Remodeling in Older Hypertensive Patients

To detect differences in potential magnetic resonance imaging biomarkers of coronary remodeling between older hypertensive patients and healthy controls. Two-dimensional black-blood coronary wall magnetic resonance imaging and 3-dimensional whole-heart coronary magnetic resonance angiography were performed on 130 participants (65-84 years), including 65 hypertensive patients and 65 healthy controls. Coronary segments derived from hypertensive participants had a higher mean coronary wall thickness, a smaller vessel area, a smaller coronary wall area, a smaller lumen area, a lower coronary distensibility index, and a higher percent of the coronary wall occupying the vessel area (PWOV) than those from healthy controls. When the average PWOV was set as an ad hoc cutoff point, coronary segments with a high PWOV had a significantly higher mean wall thickness, a higher maximum wall thickness, a smaller vessel area, a smaller lumen area, a lower coronary distensibility index, and a higher coronary plaque index compared with coronary segments with a low PWOV. Magnetic resonance techniques are able to noninvasively detect significant differences in potential imaging biomarkers of coronary remodeling between older hypertensive patients and healthy controls. The PWOV is a promising remodeling feature for quantitatively evaluating the progression of coronary atherosclerosis.

Regional Coronary Endothelial Function Is Closely Related to Local Early Coronary Atherosclerosis in Patients With Mild Coronary Artery Disease

Coronary endothelial function is abnormal in patients with established coronary artery disease and was recently shown by MRI to relate to the severity of luminal stenosis. Recent advances in MRI now allow the noninvasive assessment of both anatomic and functional (endothelial function) changes that previously required invasive studies. We tested the hypothesis that abnormal coronary endothelial function is related to measures of early atherosclerosis such as increased coronary wall thickness. Seventeen arteries in 14 healthy adults and 17 arteries in 14 patients with nonobstructive coronary artery disease were studied. To measure endothelial function, coronary MRI was performed before and during isometric handgrip exercise, an endothelial-dependent stressor, and changes in coronary cross-sectional area and flow were measured. Black blood imaging was performed to quantify coronary wall thickness and indices of arterial remodeling. The mean stress-induced change in cross-sectional area was significantly higher in healthy adults (13.5%±12.8%, mean±SD, n=17) than in those with mildly diseased arteries (-2.2%±6.8%, P<0.0001, n=17). Mean coronary wall thickness was lower in healthy subjects (0.9±0.2 mm) than in patients with coronary artery disease (1.4±0.3 mm, P<0.0001). In contrast to healthy subjects, stress-induced changes in cross-sectional area, a measure of coronary endothelial function, correlated inversely with coronary wall thickness in patients with coronary artery disease (r=-0.73, P=0.0008). There is an inverse relationship between coronary endothelial function and local coronary wall thickness in patients with coronary artery disease but not in healthy adults. These findings demonstrate that local endothelial-dependent functional changes are related to the extent of early anatomic atherosclerosis in mildly diseased arteries. This combined MRI approach enables the anatomic and functional investigation of early coronary disease.

Correlations of coronary plaque wall thickness with wall pressure and wall pressure gradient: a representative case study

BackgroundThere are two major hemodynamic stresses imposed at the blood arterial wall interface by flowing blood: the wall shear stress (WSS) acting tangentially to the wall, and the wall pressure (WP) acting normally to the wall. The role of flow wall shear stress in atherosclerosis progression has been under intensive investigation, while the impact of blood pressure on plaque progression has been under-studied.MethodThe correlations of wall thickness (WT) with wall pressure (WP, blood pressure on the lumen wall) and spatial wall pressure gradient (WPG) in a human atherosclerotic right coronary artery were studied. The pulsatile blood flow was simulated using a three dimensional mathematical model. The blood was treated as an incompressible viscous non-Newtonian fluid. The geometry of the artery was re-constructed using an in vivo intravascular ultrasound (IVUS) 44-slice dataset obtained from a patient with consent obtained. The WT, the WP and the WPG were averaged on each slice, respectively, and Pearson correlation analysis was performed on slice averaged base. Each slice was then divided into 8 segments and averaged vessel WT, WP and WPG were collected from all 352 segments for correlation analysis. Each slice was also divided into 2 segments (inner semi-wall of bend and outer semi-wall of bend) and the correlation analysis was performed on the 88 segments.ResultsUnder mean pressure, the Pearson coefficient for correlation between WT and WP was r = − 0.52 (p < 0.0001) by 2-segment analysis and r = − 0.81 (p < 0.0001) by slice averaged analysis, respectively. The Pearson coefficient for correlation between WT and WPG was r = 0.30 (p = 0.004) by 2-segment analysis and r = 0.45 (p = 0.002) by slice averaged analysis, respectively. The r-values corresponding to systole and diastole pressure conditions were similar.ConclusionsResults from this representative case report indicated that plaque wall thickness correlated negatively with wall pressure (r = −0.81 by slice) and positively with wall pressure gradient (r = 0.45). The slice averaged WT has a strong linear relationship with the slice averaged WP. Large-scale patient studies are needed to further confirm our findings.

Time-Efficient Black Blood RCA Wall Imaging at 3T Using Improved Motion Sensitized Driven Equilibrium (iMSDE): Feasibility and Reproducibility

BackgroundThe aim of this study was to explore the feasibility and reproducibility of a time-efficient coronary vessel wall measurement approach using an improved motion-sensitized driven equilibrium (iMSDE) pulse sequence.MethodologyIn this study, the iMSDE pulse sequence was first optimized and then applied on a group of healthy volunteers (N = 10) to evaluate its feasibility of vessel wall visualization. The same technique was also applied on a separate group of volunteers (N = 19) for a reproducibility study by scanning the same subject in two separate sessions. The iMSDE sequence was found to provide good coronary vessel wall delineation. It was also found to provide reproducible coronary vessel wall diameter and thickness measurements in both proximal and middle segments of the right coronary artery.ConclusionThe feasibility and reproducibility of iMSDE based coronary vessel wall imaging were demonstrated for the first time, paving the way for further testing in a clinical environment for fast and accurate coronary artery disease detection.

Noninvasive detection of coronary artery wall thickening with age in healthy subjects using high resolution MRI with beat‐to‐beat respiratory motion correction

To demonstrate coronary artery wall thickening with age in a small healthy cohort using a highly efficient, reliable, and reproducible high-resolution MR technique. A 3D cross-sectional MR vessel wall images (0.7 × 0.7 × 3 mm resolution) with retrospective beat-to-beat respiratory motion correction (B2B-RMC) were obtained in the proximal right coronary artery of 21 healthy subjects (age, 22-62 years) with no known cardiovascular disease. Lumen and outer wall (lumen + vessel wall) areas were measured in one central slice from each subject and average wall thickness and wall area/outer wall area ratio (W/OW) calculated. Imaging was successful in 18 (86%) subjects with average respiratory efficiency 99.3 ± 1.7%. Coronary vessel wall thickness and W/OW significantly correlate with subject age, increasing by 0.088 mm and 0.031 per decade respectively (R = 0.53, P = 0.024 and R = 0.48, P = 0.046). No relationship was found between lumen area and vessel wall thickness (P = NS), but outer wall area increased significantly with vessel wall thickness at 19 mm(2) per mm (P = 0.046). This is consistent with outward vessel wall remodeling. Despite the small size of our healthy cohort, using high-resolution MR imaging and B2B-RMC, we have demonstrated increasing coronary vessel wall thickness and W/OW with age. The results obtained are consistent with outward vessel wall remodeling.

Coronary arterioles in type 2 diabetic (db/db) mice undergo a distinct pattern of remodeling associated with decreased vessel stiffness

Little is known about the impact of type 2 diabetes mellitus (DM) on coronary arteriole remodeling. The aim of this study was to determine the mechanisms that underlie coronary arteriole structural remodeling in type 2 diabetic (db/db) mice. Passive structural properties of septal coronary arterioles isolated from 12- to 16-week-old diabetic db/db and control mice were assessed by pressure myography. Coronary arterioles from 12-week-old db/db mice were structurally similar to age-matched controls. By 16weeks of age, coronary wall thickness was increased in db/db arterioles (p<0.01), while luminal diameter was reduced (control: 118±5μm; db/db: 102±4μm, p<0.05), augmenting the wall-to-lumen ratio by 58% (control: 5.9±0.6; db/db: 9.5±0.4, p<0.001). Inward hypertrophic remodeling was accompanied by a 56% decrease in incremental elastic modulus (p<0.05, indicating decreased vessel coronary wall stiffness) and a ~30% reduction in coronary flow reserve (CFR) in diabetic mice. Interestingly, aortic pulse wave velocity and femoral artery incremental elastic modulus were increased (p<0.05) in db/db mice, indicating macrovascular stiffness. Molecular tissue analysis revealed increased elastin-to-collagen ratio in diabetic coronaries when compared to control and a decrease in the same ratio in the diabetic aortas. These data show that coronary arterioles isolated from type 2 diabetic mice undergo inward hypertrophic remodeling associated with decreased stiffness and increased elastin-to-collagen ratio which results in a decreased CFR. This study suggests that coronary microvessels undergo a different pattern of remodeling from macrovessels in type 2 DM.

Does heart rate influence CMR image quality of the coronary vessel wall?

Does heart rate influence CMR image quality of the coronary vessel wall?

Regional coronary endothelial function is related to local coronary wall thickness in CAD patients using 3T MRI

Background Coronary endothelial function (endoFx) is an important physiologic indicator of vascular function. Abnormal function is present in patients with established coronary disease (CAD) and was recently shown to relate to the severity of luminal stenosis. 1 However, luminal stenosis occurs late in the process of atherosclerosis, and a the extent to which abnormal coronary endoFx occurs early in atherosclerosis and whether it is related to measures of early, non-stenotic atherosclerosis, such as coronary wall thickness (CWT) are not known. Recent advances in MRI now allow non-invasive assessment of both anatomic (CWT) 2-4 and functional (endoFx) vascular properties that in the past required invasive studies, precluding evaluation of healthy subjects and low risk populations. Objective To test the hypothesis that local endothelial dependent coronary vasoreactivity is inversely related to coronary wall thickness as measured using MRI. Methods Fourteen arteries in eleven healthy adults and fourteen arteries in eleven CAD patients with <30% stenosis by recent coronary x-ray angiography were studied with 3T MRI. To measure endoFx, spiral coronary MRI was performed before and during isometric hand-grip exercise, an endothelial-dependent stressor, and coronary cross-sectional area (CSA) change was measured as previously reported. 1 For coronary vessel wall imaging, black-blood dual-inversion spiral imaging was used to quantify CWT and normalized wall index (NWI=lumen area/total area). Results The stress-induced change in CSA was significantly higher in healthy adults (15.2%±11.0%, mean±SD) than in those with mild, non-stenotic CAD (-2.3%±7.4%, p<0.0001). Mean CWT was smaller in healthy subjects (0.86±0.16mm) than in CAD patients (1.49±0.31mm, p<0.0001). In contrast to healthy subjects, coronary

Reproducibility of coronary vessel wall imaging techniques

Background Coronary wall thickness measurements must be highly reproducible to be useful in longitudinal studies. While 2D turbo-spin-echo (TSE) and spiral techniques are commonly used, 3D techniques reduce partial-volume effects and allow greater vessel coverage. Recently, 3D coronary wall imaging was demonstrated with 100% respiratory efficiency (RE) using beat-to-beat respiratory motion correction (B2B-RMC) [1] which uses motion information determined from low resolution 3D images of the fat around the vessel as a surrogate for vessel motion. Here we assess the reproducibility of this technique together with that of navigator-gated 2D TSE and spiral acquisitions. Methods Cross-sectional right coronary artery wall images were obtained in 10 healthy subjects on a Siemens 1.5T Avanto scanner using dark-blood prepared B2B-RMC 3D spiral imaging, navigator-gated 2D TSE imaging and navigator-gated 2D spiral imaging. Acquisition order was randomized and subjects were imaged on two separate occasions to assess inter-study reproducibility using the intra-class correlation-coefficient (ICC) and Bland Altman analysis. All acquisitions used 0.7x0.7mm inplane resolution. B2B-RMC 3D spiral acquisitions acquired 8x3.0mm slices (16x1.5mm reconstructed) and 2D techniques acquired 1x6mm slice. Navigator-gated techniques used a 5mm window while B2B-RMC excluded data acquired at only very extreme respiratory positions, retrospectively correcting the rest. Durations, assuming 100% RE, were 600 cardiac cycles (CC) for B2B-RMC, 75CC for 2D spiral and 202-576CC for 2D

Right coronary wall CMR in the older asymptomatic advance cohort: positive remodeling and associations with type 2 diabetes and coronary calcium.

BackgroundCoronary wall cardiovascular magnetic resonance (CMR) is a promising noninvasive approach to assess subclinical atherosclerosis, but data are limited in subjects over 60 years old, who are at increased risk. The purpose of the study was to evaluate coronary wall CMR in an asymptomatic older cohort.ResultsCross-sectional images of the proximal right coronary artery (RCA) were acquired using spiral black-blood coronary CMR (0.7 mm resolution) in 223 older, community-based patients without a history of cardiovascular disease (age 60-72 years old, 38% female). Coronary measurements (total vessel area, lumen area, wall area, and wall thickness) had small intra- and inter-observer variabilities (r = 0.93~0.99, all p < 0.0001), though one-third of these older subjects had suboptimal image quality. Increased coronary wall thickness correlated with increased coronary vessel area (p < 0.0001), consistent with positive remodeling. On multivariate analysis, type 2 diabetes was the only risk factor associated with increased coronary wall area and thickness (p = 0.03 and p = 0.007, respectively). Coronary wall CMR measures were also associated with coronary calcification (p = 0.01-0.03).ConclusionsRight coronary wall CMR in asymptomatic older subjects showed increased coronary atherosclerosis in subjects with type 2 diabetes as well as coronary calcification. Coronary wall CMR may contribute to the noninvasive assessment of subclinical coronary atherosclerosis in older, at-risk patient groups.

Coronary artery microvascular narrowing downstream of stent implantation

The aim of this study was to determine the effects of stenting on downstream coronary microvessel structure in lean Ossabaw miniature swine. Bare metal stents were deployed in the left anterior descending (LAD) coronary artery of lean male Ossabaw miniature swine having a genetic propensity to obesity and metabolic syndrome. Four weeks after stent implantation, coronary microvessels (&lt;150 μm diameter) downstream of either non‐stented (n=3) or stented (n=3) LAD were carefully isolated and mounted on a pressure myograph. After a 30‐minute equilibration period, coronary microvessel wall thickness and diameters were measured over a range of pressures (0–125 mmHg). Coronary microvessels downstream of bare metal stents exhibited a 20% decrease in luminal diameters (Non‐Stented: 123.8 ± 9.2 μm vs. Stented: 99.0 ± 12.1 μm p &lt; 0.05), while wall thicknesses were preserved (Non‐Stented: 14.1± 1.2 μm vs. Stented: 13.5 ± 0.8 μm p &gt; 0.05). The decrease in external diameter did not achieve statistical significance (Non‐Stented: 152.0 ± 10.7 μm vs. Stented: 126.0 ± 13.3 μm p = 0.05) These data suggest that bare metal stent deployment in the LAD causes downstream coronary microvessels to undergo eutrophic inward remodeling, which may contribute to chronically impaired coronary flow reserve. Support: NIH HL056046, Nationwide Children's Hospital to PAL; NIH RR013223, HL062552, UL1 RR025761, Purina TestDiet to MS.

Sympathetic dysfunction of systemic right ventricle in congenitally corrected transposition of the great arteries

We evaluate the systemic right ventricle (SRV) failure of congenitally corrected transposition of the great arteries using the scintigraphic studies in a case with 32-year-old male who improved the heart failure by the use of beta-adrenergic blockers. The myocardial perfusion sympathetic nervous system activity mismatch with preserved coronary flow and wall thickness indicates a distinctive feature as SRV cardiomyopathy, suggesting the importance of recovery of SRV sympathetic dysfunction for improving the prognosis.

Positive Remodeling of the Coronary Arteries Detected by Magnetic Resonance Imaging in an Asymptomatic Population: MESA (Multi-Ethnic Study of Atherosclerosis)

The purpose of this study was to assess coronary arterial remodeling as a marker of subclinical atherosclerosis using coronary wall magnetic resonance imaging (MRI) in an asymptomatic population-based cohort.In early atherosclerosis, compensatory enlargement of both the outer wall of the vessel as well as the lumen, termed compensatory enlargement or positive remodeling, occurs before luminal narrowing.One hundred seventy-nine participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial were evaluated using black-blood coronary wall MRI. Coronary cross-sectional area (vessel size), lumen area, and mean wall thickness of the proximal coronary arteries were measured.Men had a greater vessel size, lumen area, and mean wall thickness than women (38.3 +/- 11.3 mm2 vs. 32.6 +/- 9.4 mm2, 6.7 +/- 3.2 mm2 vs. 5.3 +/- 2.4 mm2, and 2.0 +/- 0.3 mm vs. 1.9 +/- 0.3 mm, respectively, p < 0.05). No significant coronary artery narrowing was present by magnetic resonance angiography. Overall, coronary vessel size increased 25.9 mm2 per millimeter increase in coronary wall thickness, whereas lumen area increased only slightly at 3.1 mm2 for every millimeter increase in wall thickness (difference in slopes, p < 0.0001). Adjusting for age and sex, participants with an Agatston score >0 were more likely to have wall thickness >2.0 mm (odds ratio: 2.0, 95% confidence interval: 1.01 to 3.84).Coronary wall MRI detected positive arterial remodeling in asymptomatic men and women with subclinical atherosclerosis.

Relationship Between Coronary Artery Wall Thickness Measured by 64-Slice Multidetector Computed Tomography and Cardiovascular Risk Factors

Recent studies have demonstrated the quantitative ability of contrast-enhanced multidetector computed tomography (MDCT) to evaluate not only the vessel lumen but also coronary plaque. The aim of this study was to assess the association between coronary wall thickness quantified by 64-slice MDCT and cardiovascular risk factors. A total of 149 subjects with suspected coronary artery disease were scanned by contrast-enhanced 64-slice MDCT. The maximum coronary wall thickness of each proximal segment was measured and associations with baseline coronary risk factors were analyzed. The mean maximum wall thickness of all 149 patients was 0.7+/-0.3 mm and there was a significant positive correlation with age (P<0.001) and hemoglobin (Hb) A1c (P=0.001). Patients with hypertension (0.8+/-0.3 vs 0.7+/-0.3 mm, P=0.024) and diabetes (0.9+/-0.4 vs 0.7+/-0.3 mm, P=0.002) had thicker walls than those without. Multivariate linear regression analysis demonstrated that both risk factors were independently correlated with mean maximum wall thickness. Coronary wall thickness measured by 64-slice MDCT is associated with age and HbA1c, so may add useful information to cardiovascular risk stratification.

Coronary Vessel Wall Evaluation by Magnetic Resonance Imaging in the Multi-Ethnic Study of Atherosclerosis

Coronary artery wall magnetic resonance imaging (MRI) has been developed to assess coronary lumen diameter and wall thickness. The purpose of this study was to evaluate the physiological parameters that affect the measures of coronary wall thickness using black-blood MRI pulse sequences. Eighty-seven participants (38 men and 49 women) of the Multi-Ethnic Study of Atherosclerosis were enrolled in the coronary artery wall MRI study. Cine 4-chamber imaging was used to determine the coronary artery rest period. Free-breathing whole-heart magnetic resonance angiography with motion adaptor navigator was performed to localize the coronary arteries in 64 participants. Cross-sectional free-breathing black-blood images were acquired using electrocardiogram-gated, turbo spin echo sequence. Imaging parameters were as follows: repetition time = 2 R-R intervals, time to echo = 33 milliseconds, echo train length = 13, bandwidth = 305 Hz/pixel, matrix = 416 x 416, field of view = 420 x 420 mm, and slice thickness = 4 to 5 mm. Imaging was completed in 215 (92%) of 234 coronary segments; 9 participants had incomplete scans. Mean age was 62.6 +/- 8.4 years (range, 45-81 years). Mean body mass index was 29.2 +/- 5.9 kg/m2. A higher proportion of images with quality of "good" was seen in the right coronary artery (40.5%) compared to the left main and left anterior descending coronary arteries (31.9% and 26.4%, respectively). There was a very good agreement between observers in the image quality scores (kappa = 0.79, P < 0.001). Lower heart rate, male sex, and longer coronary rest period were associated with higher image quality score (P < 0.05). Signal-to-noise ratio was higher in participants with Agatston calcium score of more than 10 in the right coronary and left main arteries (48.5 vs 69.7, P = 0.001; and 53.4 vs 61.6, P = 0.032, respectively). Improved depiction of the coronary artery wall with MRI is related to coronary rest period and atherosclerotic plaque burden as measured by calcium score and inversely related to heart rate. Because longer coronary artery rest periods are associated with improved image quality both for angiography with MRI and coronary artery wall imaging, heart rate-lowering methods in association with these techniques appear to be a logical application.

Coronary risk factors for the increased of coronary wall thickness : multi-ethnic study of atherosclerosis (MESA)

Coronary risk factors for the increased of coronary wall thickness : multi-ethnic study of atherosclerosis (MESA)

MRI detects increased coronary wall thickness in asymptomatic individuals: The multi‐ethnic study of atherosclerosis (MESA)

To evaluate the use of coronary wall MRI as a measure of atherosclerotic disease burden in an asymptomatic population free of clinical cardiovascular disease. Coronary wall magnetic resonance imaging (MRI) is a noninvasive method for evaluation of arterial wall remodeling associated with atherosclerosis. Asymptomatic participants of the Multi-Ethnic Study of Atherosclerosis (MESA) study were studied using black blood MRI. MRI-assessed coronary wall thickness was compared with computed tomography calcium score, carotid intimal-medial thickness, and risk factors for coronary artery disease. Eighty-eight arterial segments were evaluated in 38 MESA participants (mean age, 61.3+/-8.7 years). The maximum coronary wall thickness was greater for participants with two or more cardiovascular risk factors than for those with one or no risk factors (2.59+/-0.33 mm vs. 2.36+/-0.30 mm, respectively, P=0.05.) For participants with zero calcium score, the mean and maximum coronary wall thickness for subjects with two or more risk factors for coronary artery disease were greater than the wall thickness for subjects with one or no risk factors (mean thickness: 1.95+/-0.17 mm vs. 1.7+/-0.19 mm; maximum thickness: 2.67+/-0.24 mm vs. 2.32+/-0.27 mm, respectively, P<0.05). Subjects with increased carotid intimal-medial thickness also had increased coronary artery wall thickness (P<0.05). Coronary artery wall MRI detects increased coronary wall thickness in asymptomatic individuals with subclinical markers of atherosclerotic disease and in individuals with zero calcium score.

Subclinical Coronary and Aortic Atherosclerosis Detected by Magnetic Resonance Imaging in Type 1 Diabetes With and Without Diabetic Nephropathy

Patients with type 1 diabetes and nephropathy maintain an excess cardiovascular mortality compared with diabetic patients with normoalbuminuria. We sought to evaluate coronary and aortic atherosclerosis in a cohort of asymptomatic type 1 diabetic patients with and without diabetic nephropathy using cardiovascular magnetic resonance imaging. In a cross-sectional study, 136 subjects with long-standing type 1 diabetes without symptoms or history of cardiovascular disease, including 63 patients (46%) with nephropathy and 73 patients with normoalbuminuria, underwent cardiovascular magnetic resonance imaging. All subjects underwent cardiac exercise testing and noninvasive tests for peripheral artery disease and autonomic neuropathy. Coronary artery stenoses were identified in 10% of subjects with nephropathy (versus 0% with normoalbuminuria; P=0.007). Coronary plaque burden, expressed as right coronary artery mean wall thickness (1.7+/-0.3 versus 1.3+/-0.2 mm; P<0.001) and maximum right coronary artery wall thickness (2.2+/-0.5 versus 1.6+/-0.3 mm; P<0.001), was greater in subjects with nephropathy. The prevalence of thoracic (3% versus 0%; P=0.28) and abdominal aortic plaque (22% versus 16%; P=0.7) was similar in both groups. Subjects with and without abdominal aortic plaques had similar coronary plaque burden. In asymptomatic type 1 diabetes, cardiovascular magnetic resonance imaging reveals greater coronary plaque burden in subjects with nephropathy compared with those with normoalbuminuria.