Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan.
Department of Cardiology, IMS Miyoshi General Hospital, Miyoshi, Saitama, Japan.
Heart Vessels. 2021 Jun;36(6):775-781. doi: 10.1007/s00380-020-01759-x. Epub 2021 Jan 23.
Myocardial perfusion and perfusion reserve are diminished in patients with atrial fibrillation (AF). Phase-contrast (PC) cine magnetic resonance imaging (MRI) of the coronary sinus serves as a non-invasive means of quantifying coronary flow reserve (CFR) without any radioactive tracer. The present study aimed to evaluate the utility of PC cine MRI of the coronary sinus for assessing decreased CFR in patients with AF. We studied 362 patients with known or suspected coronary artery disease (CAD) [age 72 ± 9 years; 267 (74%) male; 90 (25%) had AF] and 20 age- and gender-matched control subjects [age 72 ± 9 years, 14 (70%) male]. Using a 1.5-T MR scanner and cardiac coils, blood flow of the coronary sinus (CBF) was quantified by PC cine MRI. CFR was calculated as CBF during adenosine triphosphate infusion divided by CBF at rest. CFR was significantly lower in patients with AF than in those without AF among all patients (n = 362) (2.45 ± 0.42 vs. 2.71 ± 0.58, p < 0.001), in patients with known CAD (n = 155) (2.40 ± 0.46 vs. 2.72 ± 0.58, p = 0.002), and in those with suspected CAD (n = 207) (2.49 ± 0.40 vs. 2.72 ± 0.59, p = 0.007). Significant differences in CFR were found between controls and patients without AF (3.12 ± 0.52 vs. 2.71 ± 0.58, p < 0.001). AF was independently associated with CFR in both known CAD patients [β = - 0.248, 95% confidence interval (CI): - 0.561 to - 0.119, p = 0.003) and suspected CAD patients (β = - 0.154, 95% CI - 0.353 to - 0.034, p = 0.018). The presence of AF was related to impaired CFR in both known and suspected CAD patients. PC cine MRI of the coronary sinus can be useful for detecting impaired CFR in patients with AF.
心肌灌注和灌注储备在心房颤动（AF）患者中减少。相位对比（PC）电影磁共振成像（MRI）冠状动脉窦作为一种非侵入性手段来量化冠状动脉血流储备（CFR），而无需任何放射性示踪剂。本研究旨在评估 PC 电影冠状动脉窦 MRI 用于评估 AF 患者 CFR 降低的效用。我们研究了 362 例已知或疑似冠状动脉疾病（CAD）患者[年龄 72±9 岁；267 名（74%）男性；90 名（25%）患有 AF]和 20 名年龄和性别匹配的对照组[年龄 72±9 岁，14 名（70%）男性]。使用 1.5-T MR 扫描仪和心脏线圈，通过 PC 电影 MRI 量化冠状动脉窦（CBF）的血流。CFR 计算为腺苷三磷酸输注期间的 CBF 除以休息时的 CBF。与无 AF 的患者相比，所有患者（n=362）（2.45±0.42 与 2.71±0.58，p<0.001）、已知 CAD 患者（n=155）（2.40±0.46 与 2.72±0.58，p=0.002）和疑似 CAD 患者（n=207）（2.49±0.40 与 2.72±0.59，p=0.007）中 AF 患者的 CFR 显著降低。在对照组和无 AF 的患者之间发现 CFR 有显著差异（3.12±0.52 与 2.71±0.58，p<0.001）。AF 在已知 CAD 患者[β=-0.248，95%置信区间（CI）：-0.561 至-0.119，p=0.003]和疑似 CAD 患者[β=-0.154，95%CI-0.353 至-0.034，p=0.018]中与 CFR 独立相关。AF 的存在与已知和疑似 CAD 患者的 CFR 受损有关。冠状动脉窦 PC 电影 MRI 可用于检测 AF 患者的 CFR 受损。
