Feasibility of cardiovascular magnetic resonance derived coronary wave intensity analysis

Journal of Cardiovascular Magnetic Resonance

Research

Kim H. Parker¹  Alun D. Hughes²  Justin E. Davies³  Rod H. Stables⁴  Robert Cooper⁴  Jennifer Keegan⁵  Julian Collinson⁵  Ricardo Wage⁵  Dudley J. Pennell⁵  David Firmin⁵  Peter Drivas⁵  Stephen Strain⁵  Robin Simpson⁵  Ranil de Silva⁵  Sanjay K. Prasad⁵  Carlo Di Mario⁵  Claire E. Raphael⁶  Vass Vassiliou⁷  Michael Frenneaux⁸ 

[1] Department of Bioengineering, Imperial College, London, UK;Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK;International Center for Circulatory Health, Imperial College, London, UK;Liverpool Heart and Chest Hospital, Imperial College Medical School, Liverpool, UK;NIHR Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK;NIHR Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK;Department of Cardiovascular Magnetic Resonance, Royal Brompton Hospital, Sydney Street, SW3 6NP, London, UK;NIHR Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK;NIHR Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK;Norwich Medical School, University of East Anglia, Norwich, UK;

关键词: Cardiovascular Magnetic Resonance;    Cardiac Cycle;    Left Anterior Descend;    Coronary Flow;    Right Coronary Artery;   

DOI  :  10.1186/s12968-016-0312-8

 received in 2016-07-01, accepted in 2016-12-03,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundWave intensity analysis (WIA) of the coronary arteries allows description of the predominant mechanisms influencing coronary flow over the cardiac cycle. The data are traditionally derived from pressure and velocity changes measured invasively in the coronary artery. Cardiovascular magnetic resonance (CMR) allows measurement of coronary velocities using phase velocity mapping and derivation of central aortic pressure from aortic distension. We assessed the feasibility of WIA of the coronary arteries using CMR and compared this to invasive data.MethodsCMR scans were undertaken in a serial cohort of patients who had undergone invasive WIA. Velocity maps were acquired in the proximal left anterior descending and proximal right coronary artery using a retrospectively-gated breath-hold spiral phase velocity mapping sequence with high temporal resolution (19 ms). A breath-hold segmented gradient echo sequence was used to acquire through-plane cross sectional area changes in the proximal ascending aorta which were used as a surrogate of an aortic pressure waveform after calibration with brachial blood pressure measured with a sphygmomanometer. CMR-derived aortic pressures and CMR-measured velocities were used to derive wave intensity. The CMR-derived wave intensities were compared to invasive data in 12 coronary arteries (8 left, 4 right). Waves were presented as absolute values and as a % of total wave intensity. Intra-study reproducibility of invasive and non-invasive WIA was assessed using Bland-Altman analysis and the intraclass correlation coefficient (ICC).ResultsThe combination of the CMR-derived pressure and velocity data produced the expected pattern of forward and backward compression and expansion waves. The intra-study reproducibility of the CMR derived wave intensities as a % of the total wave intensity (mean ± standard deviation of differences) was 0.0 ± 6.8%, ICC = 0.91. Intra-study reproducibility for the corresponding invasive data was 0.0 ± 4.4%, ICC = 0.96. The invasive and CMR studies showed reasonable correlation (r = 0.73) with a mean difference of 0.0 ± 11.5%.ConclusionThis proof of concept study demonstrated that CMR may be used to perform coronary WIA non-invasively with reasonable reproducibility compared to invasive WIA. The technique potentially allows WIA to be performed in a wider range of patients and pathologies than those who can be studied invasively.

【 授权许可】

CC BY   
© The Author(s). 2016