Stress/Rest Circumferential Strain in Non-Ischemia, Ischemia, and Infarction:– Quantification by 3 Tesla Tagged Magnetic Resonance Imaging –
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概要
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Background: Adenosine triphosphate (ATP) induces relative hypoperfusion in significantly stenotic coronary arteries, but its effect on myocardial strain has not been used clinically for the detection of ischemia. The purpose of this study was to quantify ATP-stress-induced contractile impairment as altered myocardial strain in coronary artery disease (CAD) using tagged magnetic resonance (MR) and to evaluate its diagnostic capability in comparison with ATP-stress myocardial perfusion-MR. Methods and Results: Tagged MR and perfusion-MR under ATP-stress and rest conditions and late gadolinium enhancement (LGE) MR imaging were performed in 22 patients with suspected CAD. The peak absolute value of the circumferential strain (C-strain) was measured in 12 segments. Myocardial segments were categorized as non-ischemic (n=201), ischemic (n=42), or infarcted (n=21) according to the perfusion-MR and LGE MR imaging results. The absolute C-strain was significantly greater under ATP-stress (19±13%) (mean±SD) than under at-rest (15±11%, P<0.001) conditions in non-ischemic segments. Conversely, the absolute C-strain was significantly lower under ATP-stress (10±13%) than under at-rest (16±6%, P<0.01) conditions in ischemic segments. Optimal cutoff values for stress C-strain (–17.5%) could successfully differentiate segments with ischemia or infarction from non-ischemic ones with a sensitivity of 86%, a specificity of 65%, and an area under the curve of 0.79. Conclusions: C-strain analysis using tagged MR could detect ATP-stress-induced contractile impairment in ischemic myocardium. (Circ J 2013; 77: 1235–1241)
著者
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Nagao Michinobu
Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine
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Miyagawa Masao
Department Of Cardiology Matsuyama Red Cross Hospital
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Kido Teruhito
Department Of Diagnostic And Therapeutic Radiology Ehime University Graduate School Of Medicine
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Mochizuki Teruhito
Department Of Cardiology Matsuyama Red Cross Hospital
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Ogimoto Akiyoshi
Department Of Cardiology Ehime National Hispital
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Kurata Akira
Department Of Cardiology Ehime University School Of Medicine
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Kido Tomoyuki
Department Of Pharmacological Sciences Faculty Of Pharmaceutical Sciences Kumamoto University
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Ogimoto Akiyoshi
Department of Cardiovascular Internal Medicine, Ehime University Graduate School of Medicine
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Miyagawa Masao
Department of Radiology, Ehime University Graduate School of Medicine
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Kurata Akira
Department of Radiology, Ehime University Graduate School of Medicine
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Kido Tomoyuki
Department of Radiology, Ehime University Graduate School of Medicine
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