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Background Obesity is associated with cardiovascular morbidity and mortality. This quantitative CMR perfusion study aims to examine the contribution of body mass index (BMI) to decreased myocardial perfusion reserve (MPR). Methods 123 patients with no obstructive epicardial coronary artery disease, defined by coronary computed tomographic angiogram demonstrating < 30% stenosis, underwent regadenoson CMR 1st-pass perfusion imaging, using 0.05 mmol/kg gadolinium (Gd) followed by rest perfusion imaging (also 0.05 mmol/kg Gd) performed 20 minutes later. The subjects were categorized into 4 groups: normal BMI (between 18.5-24.9 kg/m2, overweight (BMI 25-29.9 kg/m2), Class I obese (BMI 30-34.9), and Class II and III obese (BMI≥35). Myocardial blood flow (MBF) in ml/min/g and myocardial perfusion reserve (MPR) were quantified using a fully quantitative model constrained deconvolution.

In the absence of obstructive coronary artery disease, patients with class II and III obesity have decreased myocardial perfusion reserve