Cha Min Jae, Kim Sung Mok, Kim Hyun Su, Kim Yiseul, Choe Yeon Hyeon
1 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2 Currently, Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Acta Radiol. 2018 Nov;59(11):1300-1308. doi: 10.1177/0284185118757274. Epub 2018 Feb 12.
Background Myocardial perfusion reserve index (MPRI) and extracellular volume fraction (ECV) on cardiac magnetic resonance (CMR) are known to quantify coronary microvascular dysfunction and myocardial fibrosis, respectively. Purpose To demonstrate that cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, and smoking are correlated with MPRI and ECV on CMR in asymptomatic individuals. Material and Methods Between October 2013 and July 2014, 196 individuals underwent CMR. After excluding those with chest pain, arrhythmia, and obstructive coronary artery disease, participants were divided into five groups: those without risk factor (n = 26) and those with one (n = 43), two (n = 35), three (n = 24), or four (n = 6) risk factors. MPRI and ECV were obtained on perfusion CMR and pre- and post-T1 mapping, respectively. Results A total of 134 asymptomatic individuals (109 men, 25 women; mean age = 54.4 ± 7.08 years; body mass index [BMI] = 24.96 ± 2.76 kg/m; Framingham risk score [FRS] = 7.71 ± 5.21) were included. The Jonckheere-Terpstra test demonstrated trends of increasing BMI, FRS, and left ventricular mass index (all P values < 0.001), but decreasing MPRI ( P = 0.001) with increasing numbers of risk factors. Stepwise multiple linear regression demonstrated that an increasing number of cardiovascular risk factors was an independent predictor of MPRI ( P = 0.001). However, there was no significant association between the number of risk factors and ECV ( P = 0.99). Conclusion We demonstrated that an increasing number of cardiovascular risk factors is significantly associated with reduced MPRI, but not with ECV on CMR.
已知心脏磁共振成像（CMR）中的心肌灌注储备指数（MPRI）和细胞外容积分数（ECV）分别用于量化冠状动脉微血管功能障碍和心肌纤维化。目的：证明高血压、糖尿病、高脂血症和吸烟等心血管危险因素与无症状个体CMR上的MPRI和ECV相关。材料与方法：2013年10月至2014年7月期间，196名个体接受了CMR检查。排除有胸痛、心律失常和阻塞性冠状动脉疾病的个体后，参与者被分为五组：无危险因素组（n = 26）以及有一个（n = 43）、两个（n = 35）、三个（n = 24）或四个（n = 6）危险因素组。分别在灌注CMR以及T1映射前后获得MPRI和ECV。结果：共纳入134名无症状个体（109名男性，25名女性；平均年龄 = 54.4 ± 7.08岁；体重指数[BMI] = 24.96 ± 2.76 kg/m；弗雷明汉风险评分[FRS] = 7.71 ± 5.21）。琼克尔-特普斯特拉检验显示，随着危险因素数量增加，BMI、FRS和左心室质量指数呈上升趋势（所有P值 < 0.001），但MPRI呈下降趋势（P = 0.001）。逐步多元线性回归表明，心血管危险因素数量增加是MPRI的独立预测因素（P = 0.001）。然而，危险因素数量与ECV之间无显著关联（P = 0.99）。结论：我们证明，心血管危险因素数量增加与CMR上MPRI降低显著相关，但与ECV无关。
