PERFUSION CARDIAC MAGNETIC RESONANCE WITH ADENOSINE TRIPHOSPHATE IN THE DIAGNOSIS OF MYOCARDIAL ISCHEMIA
Stukalova O.V.1, Pivovarova A.I.1, Soboleva G.N.1, Ternovoy S.K.1,2, Karpov Y.A.1
1 E.I. Chazov National medical research centre of cardiology.
2 I.M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia.
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urpose. To show abilities of stress cardiac magnetic resonance (CMR) in diagnostics of myocardial ischemia; to evaluate the tolerance of using adenosine triphosphate (ATP) in perfusion cardiac magnetic resonance in diagnostics of myocardial ischemia.
Materials and methods. Perfusion stress CMR was provided in 40 patients with suspected or known ischemic heart disease. ATP was used for pharmacological stress in dose 160 mkg/kg/min during 3-5 min. Stress-induced perfusion myocardial defect was defined as the area of low signal intensity during the first pass of contrast on 3 and more following images.
Results. Severe adverse effects of ATP infusion were not detected. The chance of appearance perfusion defect in zone, associated with atherosclerosis obstruction in coronary arteries, were higher more than 2 times (ОR = 2.62 (1.06-6.66), р=0,038) compared to the zones supplied with blood by unaltered coronary arteries. In 7 patients, subendocardial perfusion defects were found in slightly altered coronary arteries and had a circular diffuse character.
Conclusion. ATP is a safe stress agent for perfusion cardiac magnetic resonance. Diagnostics myocardial ischaemia become possible due to detection of perfusion defects in subendocardial zone in consequence not only of obstructive coronary artery disease but also as a result of coronary microvascular dysfunction.
Keywords: perfusion cardiac MR, stress CMR, adenosine triphosphate, myocardial ischaemia, myocardial perfusion.
Corresponding author: Pivovarova A.I., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Stukalova O.V., Pivovarova A.I., Soboleva G.N., Ternovoy S.K., Karpov Y.A. Perfusion cardiac magnetic resonance with adenosine triphosphate in the diagnosis of myocardial ischemia. REJR 2023; 13(2):63-74. DOI: 10.21569/2222-7415-2023-13-2-63-74.
Received: 02.04.23 Accepted: 28.05.23