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Hypertrophic Cardiomyopathy: MR Measurement of Coronary Blood Flow and Vasodilator Flow Reserve in Patients and Healthy Subjects¹

¹ From the Departments of Radiology (N.K., H.S., K.T.) and Internal Medicine (T.Y., N.I., T.N.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan; and the Department of Radiology, University of California, San Francisco (C.B.H.). From the 1997 RSNA scientific assembly. Received May 11, 1998; revision requested July 10; revision received September 9; accepted October 27. Address reprint requests to N.K.

PURPOSE: To evaluate coronary blood flow per gram of myocardial mass and vasodilator flow reserve in patients with hypertrophic cardiomyopathy (HCM) and in healthy subjects by using breath-hold velocity-encoded cine (VEC) magnetic resonance (MR) imaging.

MATERIALS AND METHODS: Twenty-nine patients with HCM and nine healthy volunteers were examined. Fast VEC MR images were obtained in an oblique imaging plane perpendicular to the coronary sinus before and after intravenous injection of dipyridamole (0.56 mg/kg). The products of mean velocity and cross-sectional area of the vessel were integrated to measure blood flow. Breath-hold cine MR images encompassing the entire left ventricle were acquired to quantify the left ventricular mass.

RESULTS: In the basal state, the coronary blood flow per gram of myocardial mass was 0.74 mL/min/g ± 0.23 in healthy subjects and 0.62 mL/min/g ± 0.27 in patients with HCM. After administration of dipyridamole, coronary blood flow in patients with HCM increased to a level significantly less than that in healthy subjects (1.03 mL/min/g ± 0.40 vs 2.14 mL/min/g ± 0.51; P < .01), resulting in a severely depressed flow reserve ratio in patients with HCM compared with that in healthy subjects (1.72 ± 0.49 vs 3.01 ± 0.75; P < .01).

CONCLUSION: Breath-hold VEC MR imaging is a noninvasive technique for evaluating coronary flow per gram of myocardial mass and coronary flow reserve.

Index terms: Coronary vessels, flow dynamics, 511.12144, 547.12144 • Coronary vessels, MR, 511.12144, 547.12144 • Heart, cardiomyopathy, 51.12144, 51.86, 524.12144 • Heart, hypertrophy, 51.12144, 524.87 • Myocardium, blood supply, 511.12144 • Myocardium, MR, 511.12144

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