An acute increase in Left Atrial volume and left ventricular filling pressure during Adenosine administered myocardial hyperaemia: CMR First-Pass Perfusion Study

BMC Cardiovascular Disorders

Research

Samer Alabed¹  Andrew J Swift¹  Gareth Williams¹  Abdallah Al-Mohammad²  Fabrizio Ricci³  John P Greenwood⁴  Sven Plein⁴  Wasim Javed⁴  Mohammed Y Khanji⁵  Chris Sawh⁶  Peter Swoboda⁷  Vassilios S Vassiliou⁸  Ciaran Grafton-Clarke⁸  Hosamadin Assadi⁸  Pankaj Garg⁹ 

[1] Department of Infection, Immunity and Cardiovascular disease, University of Sheffield Medical School and Sheffield Teaching Hospitals NHS Trust, Sheffield, UK;Department of Infection, Immunity and Cardiovascular disease, University of Sheffield Medical School and Sheffield Teaching Hospitals NHS Trust, Sheffield, UK;Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;Department of Neuroscience, Imaging and Clinical Sciences, “G.d’Annunzio” University of Chieti-Pescara, Chieti, Italy;Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK;NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK;Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK;Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK;Norwich Medical School, Norwich Research Park, NR4 7UQ, Norwich, UK;University of East Anglia, Norwich Medical School, Norwich, Norfolk, UK;Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK;University of East Anglia, Norwich Medical School, Norwich, Norfolk, UK;Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK;Department of Infection, Immunity and Cardiovascular disease, University of Sheffield Medical School and Sheffield Teaching Hospitals NHS Trust, Sheffield, UK;Norwich Medical School, Norwich Research Park, NR4 7UQ, Norwich, UK;

关键词: Cardiovascular magnetic resonance;    Left ventricular end-diastolic pressure;    MRI;    Left atrium;    Haemodynamics;   

DOI  :  10.1186/s12872-023-03230-x

 received in 2023-02-03, accepted in 2023-04-07,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveTo investigate whether left atrial (LA) volume and left ventricular filling pressure (LVFP) assessed by cardiovascular magnetic resonance (CMR) change during adenosine delivered myocardial hyperaemia as part of a first-pass stress perfusion study.Methods and resultsWe enrolled 33 patients who had stress CMR. These patients had a baseline four-chamber cine and stress four-chamber cine, which was done at peak myocardial hyperaemic state after administering adenosine. The left and right atria were segmented in the end ventricular diastolic and systolic phases. Short-axis cine stack was segmented for ventricular functional assessment. At peak hyperaemic state, left atrial end ventricular systolic volume just before mitral valve opening increased significantly from baseline in all (91 ± 35ml vs. 81 ± 33ml, P = 0.0002), in males only (99 ± 35ml vs. 88 ± 33ml, P = 0.002) and females only (70 ± 26ml vs. 62 ± 22ml, P = 0.02). The right atrial end ventricular systolic volume increased less significantly from baseline (68 ± 21ml vs. 63 ± 20ml, P = 0.0448). CMR-derived LVFP (equivalent to pulmonary capillary wedge pressure) increased significantly at the peak hyperaemic state in all (15.1 ± 2.9mmHg vs. 14.4 ± 2.8mmHg, P = 0.0002), females only (12.9 ± 2.1mmHg vs. 12.3 ± 1.9mmHg, P = 0.029) and males only (15.9 ± 2.8mmHg vs. 15.2 ± 2.7mmHg, P = 0.002) cohorts.ConclusionLeft atrial volume assessment by CMR can measure acute and dynamic changes in preloading conditions on the left ventricle. During adenosine administered first-pass perfusion CMR, left atrial volume and LVFP rise significantly.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 8

Fig. 7

Fig. 5

40517_2023_256_Article_IEq58.gif

41116_2023_36_Article_IEq114.gif