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Cardiovascular medicine
Research
High reproducibility of adenosine stress cardiac MR myocardial perfusion imaging in patients with non-ischaemic dilated cardiomyopathy
  1. Mark A Lawson1,
  2. Susan P Bell1,
  3. Douglas W Adkisson1,
  4. Li Wang2,
  5. Henry Ooi1,3,
  6. Douglas B Sawyer1,
  7. Marvin W Kronenberg1,3
  1. 1Division of Cardiovascular Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  2. 2Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  3. 3Cardiology Section, Department of Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee, USA
  1. Correspondence to Dr Marvin W Kronenberg; marvin.w.kronenberg{at}vanderbilt.edu

Abstract

Objective To evaluate the reproducibility of first-pass contrast-enhanced cardiac MR (CMR) myocardial perfusion imaging in patients with non-ischaemic dilated cardiomyopathy (NIDCM).

Design Prospective observational study.

Setting Single centre, tertiary care hospital.

Participants 6 outpatient participants with NIDCM.

Outcome Reproducibility of semiquantitative myocardial perfusion analysis by CMR.

Method 6 patients with NIDCM were studied twice using first-pass of contrast transit through the left ventricular (LV) myocardium with a saturation-recovery gradient echo sequence at rest and during adenosine-induced hyperaemia. The anterior wall was divided into endocardial (Endo) and epicardial (Epi) segments. The Myocardial Perfusion Index (MPI) was calculated as the myocardial signal augmentation rate normalised to the LV cavity rate. The Myocardial Perfusion Reserve Index (MPRI) was calculated as hyperaemic/resting MPI.

Results Between study 1 and 2, median MPI was similar for resting Endo (0.076 vs 0.077), hyperaemic Endo (0.143 vs 0.143), resting Epi (0.073 vs 0.074), and hyperaemic Epi (0.135 vs 0.134). Median MPRI was similar for Endo (1.84 vs 1.87) and Epi (1.90 vs 2.00). Combining Endo and Epi MPI (N=12), there was excellent agreement between Study 1 and 2 for resting MPI (r=0.998, intraclass correlation coefficient (ICC) 0.998, coefficients of variation (CoV) 1.4%), hyperaemic MPI (r=0.979, ICC 0.963, CoV 3.3%) and MPRI (r=0.989, ICC 0.94, CoV 3.8%).

Conclusions Resting and hyperaemic myocardial perfusion using a normalised upslope analysis during adenosine CMR is a highly reproducible technique in patients with NIDCM.

Trial registration number Clinical Trials.Gov ID NCT00574119.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-005984

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