Open AccessImpairment of Coronary Flow Reserve Evaluated by Phase Contrast Cine‐Magnetic Resonance Imaging in Patients With Heart Failure With Preserved Ejection Fraction
Author(s) -
Kato Shingo,
Saito Naka,
Kirigaya Hidekuni,
Gyotoku Daiki,
Iinuma Naoki,
Kusakawa Yuka,
Iguchi Kohei,
Nakachi Tatsuya,
Fukui Kazuki,
Futaki Masaaki,
Iwasawa Tae,
Kimura Kazuo,
Umemura Satoshi
Publication year - 2016
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.115.002649
Subject(s) - medicine , coronary flow reserve , cardiology , coronary sinus , ejection fraction , left ventricular hypertrophy , heart failure with preserved ejection fraction , magnetic resonance imaging , heart failure , cardiac magnetic resonance imaging , coronary artery disease , blood pressure , radiology
Background Phase contrast ( PC ) cine‐magnetic resonance imaging ( MRI ) of the coronary sinus allows for noninvasive evaluation of coronary flow reserve ( CFR ), which is an index of left ventricular microvascular function. The objective of this study was to investigate coronary flow reserve in patients with heart failure with preserved ejection fraction ( HF p EF ). Methods and Results We studied 25 patients with HF p EF (mean and SD of age: 73±7 years), 13 with hypertensive left ventricular hypertrophy ( LVH ) (67±10 years), and 18 controls (65±15 years). Breath‐hold PC cine‐ MRI images of the coronary sinus were obtained to assess blood flow at rest and during ATP infusion. CFR was calculated as coronary sinus blood flow during ATP infusion divided by coronary sinus blood flow at rest. Impairment of CFR was defined as CFR <2.5 according to a previous study. The majority (76%) of HF p EF patients had decreased CFR . CFR was significantly decreased in HF p EF patients in comparison to hypertensive LVH patients and control subjects ( CFR : 2.21±0.55 in HF p EF vs 3.05±0.74 in hypertensive LVH , 3.83±0.73 in controls; P <0.001 by 1‐way ANOVA ). According to multivariable linear regression analysis, CFR independently and significantly correlated with serum brain natriuretic peptide level (β=−68.0; 95% CI, −116.2 to −19.7; P =0.007). Conclusions CFR was significantly lower in patients with HF p EF than in hypertensive LVH patients and controls. These results indicated that impairment of CFR might be a pathophysiological factor for HF p EF and might be related to HF p EF disease severity.