Residual myocardial hyperemia in regadenoson stress/rest quantitative perfusion cardiac magnetic resonance.

IF 4.8 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiologia Medica Pub Date : 2025-08-23 DOI:10.1007/s11547-025-02062-3

Gorka Bastarrika, Ana Ezponda, Javier Muñiz-Sáenz-Diez, Marta Vidorreta, Amaia Ochoa González, Juan José Gavira, Nahikari Salterain

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引用次数: 0

Abstract

Purpose: This study sought to investigate the presence of residual myocardial hyperemia on the recovery phase in patients undergoing stress CMR.

Material and methods: Fifty patients with clinical indication for stress CMR underwent quantitative perfusion imaging in resting conditions, after regadenoson-induced hyperemia (400 mcg, 5 mL), and 10 min after recovery with euphylline. Studies showing hypoperfusion due to ischemia and/or prior myocardial infarction were excluded. Global myocardial blood flow during rest (MBF_rest), stress (MBF_stress) and recovery (MBF_recovery) and MPR indices (MPR_stress/rest and MPR_{stress/recovery}) were calculated using automated pixel-wise quantitative myocardial perfusion mapping.

Results: A total of 30 patients (22 males, mean age of 62.7 ± 1 years) were included in the analysis. Global MBF_rest and MBF_stress were 0.83 ± 0.2 mL/g/min and 2.1 ± 0.6 mL/g/min, respectively. After recovery with euphylline, myocardial perfusion did not return to the resting values (MBF_recovery of 0.92 ± 0.3 mL/g/min) and statistically differed from MBF_rest (p < 0.01), suggesting residual myocardial hyperemia. This resulted in an abnormally low MPR_{stress/recovery} (2.43 ± 0.7) with respect to MPR_stress/rest (2.56 ± 0.7) (p = 0.03). A linear mixed-effects model accounting for repeated measures revealed statistically significant group differences over time in global MBF (mean difference 0.1, 95% CI 0.02-0.17, p = 0.01) and global MPR (mean difference -0.13, 95% CI -0.25 to -0.02, p = 0.02).

Conclusion: Despite the use of euphylline to counteract the vasodilator effect, MBF does not completely revert to resting values and MBF_recovery cannot be used as a substitute for MBF_rest when regadenoson is used. Consequently, a rest/stress protocol is advised for quantitative CMR perfusion to obtain accurate MBF and MPR parameters.

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心脏磁共振摄心腺苷应激/休息定量灌注的残余心肌充血。

目的：本研究旨在探讨应激性CMR患者恢复期残余心肌充血的存在。材料与方法：50例有应激性CMR临床指征的患者，分别在静息状态、再腺苷酸诱导充血（400 mcg, 5 mL）后和用euphyline恢复后10分钟进行定量灌注成像。排除了因缺血和/或既往心肌梗死导致的灌注不足的研究。使用自动逐像素定量心肌灌注制图计算休息（MBFrest）、应激（mbfrstress）和恢复（mbfrerecovery）期间的心肌血流和MPR指数（MPRstress/rest和MPRstress/recovery）。结果：共纳入30例患者，其中男性22例，平均年龄62.7±1岁。Global MBFrest和mbstress分别为0.83±0.2 mL/g/min和2.1±0.6 mL/g/min。经euphyline恢复后，心肌灌注未恢复到静息值（mbfrerecovery为0.92±0.3 mL/g/min），与MBFrest （p stress/recovery(2.43±0.7)）相比，与MPRstress/rest（2.56±0.7）相比，差异有统计学意义（p = 0.03）。考虑重复测量的线性混合效应模型显示，随着时间的推移，全球MBF（平均差值0.1,95% CI 0.02-0.17, p = 0.01）和全球MPR（平均差值-0.13,95% CI -0.25至-0.02,p = 0.02）的组间差异具有统计学意义。结论：尽管使用了euphyline来抵消血管舒张作用，但MBF并不能完全恢复到静息值，并且当使用regadenoson时，MBFrecovery不能替代MBFrecovery。因此，建议采用休息/应激方案进行定量CMR灌注，以获得准确的MBF和MPR参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiologia Medica 医学-核医学

CiteScore

14.10

自引率

7.90%

发文量

133

审稿时长

4-8 weeks

期刊介绍： Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.