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Eur Heart J Cardiovasc Imaging. 2016 Dec;17(12):1414-1423. Epub 2015 Dec 24.

Perfusion dyssynchrony analysis.

Author information

1
Division of Imaging Sciences and Biomedical Engineering, Department of Cardiovascular Imaging, King's College London, 4th Floor Lambeth Wing, St Thomas' Hospital, London SE1 7EH, UK amedeo.chiribiri@kcl.ac.uk.
2
Division of Imaging Sciences and Biomedical Engineering, Department of Cardiovascular Imaging, King's College London, 4th Floor Lambeth Wing, St Thomas' Hospital, London SE1 7EH, UK.
3
Philips Healthcare, Imaging Systems-MR Eindhoven, The Netherlands.
4
Eindhoven University of Technology, Biomedical Engineering, Biomedical Image Analysis, Eindhoven, The Netherlands.
5
DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt/Main, Frankfurt am Main, Germany.

Abstract

AIMS:

We sought to describe perfusion dyssynchrony analysis specifically to exploit the high temporal resolution of stress perfusion CMR. This novel approach detects differences in the temporal distribution of the wash-in of contrast agent across the left ventricular wall.

METHODS AND RESULTS:

Ninety-eight patients with suspected coronary artery disease (CAD) were retrospectively identified. All patients had undergone perfusion CMR at 3T and invasive angiography with fractional flow reserve (FFR) of lesions visually judged >50% stenosis. Stress images were analysed using four different perfusion dyssynchrony indices: the variance and coefficient of variation of the time to maximum signal upslope (V-TTMU and C-TTMU) and the variance and coefficient of variation of the time to peak myocardial signal enhancement (V-TTP and C-TTP). Patients were classified according to the number of vessels with haemodynamically significant CAD indicated by FFR <0.8. All indices of perfusion dyssynchrony were capable of identifying the presence of significant CAD. C-TTP >10% identified CAD with sensitivity 0.889, specificity 0.857 (P < 0.0001). All indices correlated with the number of diseased vessels. C-TTP >12% identified multi-vessel disease with sensitivity 0.806, specificity 0.657 (P < 0.0001). C-TTP was also the dyssynchrony index with the best inter- and intra-observer reproducibility. Perfusion dyssynchrony indices showed weak correlation with other invasive and non-invasive measurements of the severity of ischaemia, including FFR, visual ischaemic burden, and MPR.

CONCLUSION:

These findings suggest that perfusion dyssynchrony analysis is a robust novel approach to the analysis of first-pass perfusion and has the potential to add complementary information to aid assessment of CAD.

KEYWORDS:

adenosine; dyssynchrony analysis; gadolinium; perfusion

PMID:
26705485
PMCID:
PMC5155575
DOI:
10.1093/ehjci/jev326
[Indexed for MEDLINE]
Free PMC Article

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