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DOI: 10.1148/radiol.2271012156
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(Radiology 2003;227:209-215.)
© RSNA, 2003

Cardiac Imaging

Chronic Heart Failure: Global Left Ventricular Perfusion and Coronary Flow Reserve with Velocity-encoded Cine MR Imaging: Initial Results1

Gunnar K. Lund, MD, Norbert Watzinger, MD, Maythem Saeed, DVM, PhD, Gautham P. Reddy, MD, Ming Yang, MD, Phillip A. Araoz, MD, Dominick Curatola, MD, Martin Bedigian, MD and Charles B. Higgins, MD

1 From the Department of Radiology, University of California, San Francisco, 505 Parnassus Ave, Rm L-308, San Francisco, CA 94143-0628 (G.K.L., N.W., M.S., G.P.R., M.Y., P.A.A., C.B.H.); Altos Cardiovascular, Los Altos, Calif (D.C.); and Novartis Pharmaceuticals, East Hanover, NJ (M.B.). Received January 14, 2002; revision requested March 5; final revision received August 13; accepted August 26. Supported in part by Novartis Pharmaceuticals, East Hanover, NJ. G.K.L. supported in part by a scholarship from the University Hospital Eppendorf, Hamburg, Germany. N.W. supported by a scholarship from the Max-Kade Foundation, New York, NY. Address correspondence to C.B.H. (e-mail: charles.higgins@radiology.ucsf.edu).

PURPOSE: To quantify and compare global left ventricular (LV) perfusion and coronary flow reserve (CFR) in patients with chronic heart failure and in healthy volunteers by measuring coronary sinus flow with velocity-encoded cine (VEC) magnetic resonance (MR) imaging.

MATERIALS AND METHODS: MR measurements were performed in 10 consecutive patients with chronic heart failure due to coronary artery disease and in 10 volunteers. Global LV perfusion was quantified by measuring coronary sinus flow in an oblique imaging plane perpendicular to the coronary sinus with non–breath-hold VEC MR imaging. LV mass was measured by means of cine imaging that encompassed the heart. LV perfusion was calculated from coronary sinus flow and mass. CFR was measured from LV perfusion at rest and that after infusion of dipyridamole. Analysis of covariance was used to determine differences between groups. Differences within groups were analyzed by means of the Student t test for paired data. Regression analysis was used to determine correlation between CFR and LV ejection fraction.

RESULTS: At rest, LV perfusion was not significantly different in patients with chronic heart failure (0.46 mL/min/g ± 0.19) and volunteers (0.52 mL/min/g ± 0.21, P = .54). After administration of dipyridamole, LV perfusion was less than half in patients with chronic heart failure compared with that in volunteers (1.07 mL/min/g ± 0.64 vs 2.19 mL/min/g ± 0.98) (P = .03). CFR was severely reduced in patients with chronic heart failure compared with that in volunteers (2.3 ± 0.9 vs 4.2 ± 1.5, P = .01). A moderate but significant correlation was found between CFR and LV ejection fraction (r = 0.54, P = .02)

CONCLUSION: Combined cine and VEC MR imaging revealed that patients with chronic heart failure have normal LV perfusion at rest but severely depressed LV perfusion after vasodilation. Impaired CFR may contribute to progressive decline in LV function in patients with chronic heart failure.

© RSNA, 2003

Index terms: Heart, flow dynamics, 50.77, 524.12144, 5475.12144, 58.12144 • Heart, MR, 524.12144, 5475.12144, 58.12144 • Heart, ventricles, 511.12144 • Magnetic resonance (MR), perfusion study, 524.12144, 5475.12144, 58.12144




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