Adenosine stress CMR perfusion imaging of the temporal evolution of perfusion defects in a porcine model of progressive obstructive coronary artery occlusion. (2nd August 2019)

• Record Type: Journal Article
• Authors: Van Houten, M.; Yang, Y.; Hauser, A.; Glover, D.K.; Gan, L‐M.; Yeager, M.; Salerno, M.
• Is Part Of: NMR in biomedicine. Volume 32:Number 11(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-08-02
• Subjects: ameroid occlusion -- animal validation -- cardiac magnetic resonance -- coronary artery disease -- myocardial infarction -- myocardial ischemia -- quantitative perfusion; Nuclear magnetic resonance -- Periodicals; Magnetic Resonance Spectroscopy -- Periodicals; 574
• DOI: 10.1002/nbm.4136
• Languages: English
• ISSNs: 0952-3480

Abstract

Abstract : Adenosine stress CMR perfusion imaging can quantify absolute perfusion and myocardial perfusion reserve (MPR) in coronary artery disease (CAD) with higher spatial resolution than positron emission tomography, the only clinically available technique for quantitative myocardial perfusion imaging. While porcine models of CAD are excellent for studying perfusion abnormalities in chronic CAD, to date there are a limited number of studies that use quantitative perfusion for evaluation. Therefore, we developed an adenosine stress CMR protocol to evaluate the temporal evolution of perfusion defects in a porcine model of progressive obstructive CAD. 10 Yucatan minipigs underwent placement of an ameroid occluder around the left circumflex artery (LCX) to induce a progressive chronic coronary obstruction. Four animals underwent a hemodynamic dose range experiment to determine the adenosine dose inducing maximal hyperemia. Each animal had a CMR examination, including stress/rest spiral quantitative perfusion imaging at baseline and 1, 3, and 6 weeks. Late gadolinium enhancement images determined the presence of myocardial infarction, if any existed. Pixelwise quantitative perfusion maps were generated using Fermi deconvolution. The results were statistically analyzed with a repeated mixed measures model to block for physiological variation between the animals. Five animals developed myocardial infarction by 3 weeks, while three developed ischemia without an infarction. The perfusion defects were located in the inferolateral myocardium in the perfusion territory of the LCX. Stress perfusion values were higher in remote segments than both the infarcted and ischemic segments ( p < 0.01). MPR values were significantly greater in the remote segments than infarcted and ischemic segments ( p < 0.01). While the MPR decreased in all segments, the MPR recovered by the sixth week in the remote regions. We developed a model of progressive CAD and evaluated the temporal evolution of the development of quantitative perfusion defects. This model will serve as a platform for understanding the development of perfusion abnormalities in chronic occlusive CAD. Abstract : 10 Yucatan minipigs underwent a longitudinal CMR quantitative perfusion study to evaluate the temporal evolution of progressive obstructive coronary artery occlusion. The study followed the development of quantitative perfusion defects in this ameroid occlusion model