Myocardial perfusion reserve is low in heart transplant patients and is related to exercise capacity

IF 1.7 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2026-07-16 DOI:10.1111/cpf.70082

Kristian Dimovski, Grunde Gjesdal, Katarina Steding-Ehrenborg, Robert Jablonowski, Hui Xue, Peter Kellman, Oscar Braun, Håkan Arheden, Henrik Engblom

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Abstract

Aims

Heart transplant (HTx) patients are known to be at risk of coronary microvascular dysfunction as well as having decreased exercise capacity. The aim of this study was to investigate if microvascular function in HTx patients differs from healthy controls and is related to objective measures of exercise capacity.

Methods and Results

Twenty-nine HTx patients (51 ± 15 years, 34% women) and 26 healthy controls (57 ± 10 years, 38% women) underwent CMR. Quantitative myocardial perfusion maps were acquired using single-bolus (0.05 mmol/kg), dual-sequence perfusion mapping at adenosine stress and at rest. In addition, all HTx patients performed a maximal cardiopulmonary exercise test with gas-exchange analysis for objective assessment of exercise capacity. Heart transplant patients had lower stress myocardial perfusion (2.9 ± 0.8 vs 3.4 ± 0.8, p = 0.03) and lower myocardial perfusion reserve (MPR) (2.7 ± 0.7 vs 3.8 ± 1.2, p < 0.001) compared to healthy controls. Furthermore, MPR in HTx patients was correlated with maximal workload (R² = 0.25, p = 0.016), O₂ pulse (R² = 0.21, p = 0.026), peak O₂ consumption (VO₂ peak) (R² = 0.25, p = 0.015) and O₂ consumption (VO₂) at the anaerobic threshold (AT) (R² = 0.27, p = 0.011).

Conclusion

Microvascular function as assessed by quantitative CMR perfusion mapping is lower in HTx patients than in healthy controls and is partly related to objective measures of exercise capacity.

Abstract Image

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心脏移植患者心肌灌注储备较低，与运动能力有关

目的心脏移植（HTx）患者存在冠状动脉微血管功能障碍和运动能力下降的风险。本研究的目的是调查HTx患者的微血管功能是否与健康对照不同，是否与运动能力的客观测量有关。方法与结果29例HTx患者（51±15岁，女性34%）和26例健康对照（57±10岁，女性38%）行CMR。在腺苷应激和静息状态下，采用单剂量（0.05 mmol/kg）、双序列灌注作图获得定量心肌灌注图。此外，所有HTx患者都进行了最大心肺运动试验和气体交换分析，以客观评估运动能力。与健康对照组相比，心脏移植患者心肌灌注负荷（2.9±0.8 vs 3.4±0.8,p = 0.03）和心肌灌注储备（MPR）（2.7±0.7 vs 3.8±1.2,p < 0.001）较低。此外，HTx患者的MPR与最大负荷（R2 = 0.25, p = 0.016）、氧脉冲（R2 = 0.21, p = 0.026）、峰值耗氧量（VO2峰值）（R2 = 0.25, p = 0.015）和无氧阈（at）耗氧量（VO2）（R2 = 0.27, p = 0.011）相关。结论定量CMR灌注显像评估HTx患者微血管功能低于健康对照组，这与运动能力的客观测量有一定关系。

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

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.