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Markley, Roshanak; Del Buono, Marco Giuseppe; Mihalick, Virginia; Pandelidis, Alexander; Trankle, Cory; Jordan, Jennifer H.; Decamp, Kevin; Winston, Chris; Carbone, Salvatore; Billingsley, Hayley; Barron, Andrew; Thomas, Georgia; Van Tassell, Benjamin; Hundley, W. Gregory; Kellman, Peter; Abbate, Antonio

Abnormal left ventricular subendocardial perfusion and diastolic function in women with obesity and heart failure and preserved ejection fraction

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  • Media type: E-Article
  • Title: Abnormal left ventricular subendocardial perfusion and diastolic function in women with obesity and heart failure and preserved ejection fraction
  • Contributor: Markley, Roshanak; Del Buono, Marco Giuseppe; Mihalick, Virginia; Pandelidis, Alexander; Trankle, Cory; Jordan, Jennifer H.; Decamp, Kevin; Winston, Chris; Carbone, Salvatore; Billingsley, Hayley; Barron, Andrew; Thomas, Georgia; Van Tassell, Benjamin; Hundley, W. Gregory; Kellman, Peter; Abbate, Antonio
  • imprint: Springer Science and Business Media LLC, 2023
  • Published in: The International Journal of Cardiovascular Imaging
  • Language: English
  • DOI: 10.1007/s10554-022-02782-x
  • ISSN: 1875-8312
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>– Coronary microvascular dysfunction (CMD) is common in patients with heart failure with preserved ejection fraction (HFpEF) and obesity. Stress cardiovascular magnetic resonance (CMR) has been proposed as a non-invasive tool for detection of CMD. The aim of this study was to determine relationship between CMD and diastolic function in patients with HFpEF using a novel CMR technique.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>– Patients with obesity and HFpEF without epicardial coronary artery disease (CAD) underwent Doppler echocardiography to measure diastolic function, followed by vasodilator stress CMR, using a single bolus, dual sequence, quantitative myocardial perfusion mapping to measure myocardial blood flow (MBF) at rest and at peak hyperemia. With this, myocardial perfusion reserve (MPR), global stress endocardial-to-epicardial (endo:epi) perfusion ratio, and total ischemic burden (IB, defined as myocardial segments with MBF &lt; 1.94 mL/min/g) were calculated. Results are reported as median and interquartile range.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>– Nineteen subjects were enrolled (100% female, 42% Black). Median age was 64 [56–72] years. Global stress MBF was 2.43 ml/min/g [2.16–2.78] and global myocardial perfusion reserve (MPR) was 2.34 [2.07–2.88]. All had an abnormal subendocardial perfusion with an endo:epi of less than 1 (0.87 [0.81–0.90]). Regional myocardial hypoperfusion was detected in 14 (74%) patients with an IB of 6% [0-34.4]. Endo:epi ratio significantly correlated with IB (R=-0.510, p = 0.026) and measures of diastolic function (R = 0.531, p = 0.019 and R=-0.544, p = 0.014 for e’ and E/e’ respectively).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>– Using a novel quantitative stress CMR myocardial perfusion mapping technique, women with obesity and HFpEF were found to have patterns of abnormal subendocardial perfusion which significantly correlated with measures of diastolic dysfunction.</jats:p> </jats:sec>