Sequential coronary artery endothelial function measurements differ in CAD patients and healthy subjects: a cardiac MRI
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Sequential coronary artery endothelial function measurements differ in CAD patients and healthy subjects: a cardiac MRI study Sebastian Kelle*1, Allison G Hays2, Glenn A Hirsch2, Angela Steinberg2, Michael Schär3, Robert G Weiss2, Gary Gerstenblith2 and Matthias Stuber2 Address: 1German Heart Institute Berlin, Berlin, Germany, 2Johns Hopkins University, Baltimore, MD, USA and 3Philips Healthcare, Cleveland, OH, USA * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):O84
doi:10.1186/1532-429X-12-S1-O84
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/O84 © 2010 Kelle et al; licensee BioMed Central Ltd.
Introduction Sequential studies allowing paired comparisons of artery dimension and blood flow responses to endothelialdependent stresses before and following an acute intervention are often used to assess endothelial function. This paradigm is only valid, however, if the second response does not differ from the first in the absence of an intervention.
Purpose We evaluated the validity of this paradigm for coronary arteries using MRI in healthy subjects and in those with coronary disease, using isometric handgrip (IHG) as the endothelial-dependent stressor.
Methods Coronary artery cross-sectional area and blood flow were quantified before and during two sequential IHG stresses in twenty healthy adult subjects and 12 CAD patients using a commercial 3.0 Tesla (T) whole-body MR imaging system (Achieva 3.0 T; Philips, Best, NL). The second study was performed after 10 minutes, when hemodynamic parameters had returned to baseline values.
Results In healthy adult subjects, baseline, resting values prior to the first and second IHG stresses were similar (1. vs. 2. area: 10.1 ± 2.8 vs. 10.3 ± 2.4 mm2, p = 0.51.; blood-flow: 63.2 ± 24.9 vs. 63.1 ± 29.4 ml/min, p = 0.98). In healthy
subjects, coronary arteries dilated and blood-flow increased during IHG and the change and absolute values did not differ between the first and second IHG stresses (1. stress vs. 2. stress %-area-change: 14.8. ± 18.2 vs. 17.2 ± 13.3%, p = 0.53; %-blood-flow-change: 48.5 ± 44.7 vs. 51.1 ± 35.5%, p = 0.75). In CAD patients, however, despite the return of pulse and blood pressure to the preIHG measures, coronary cross-sectional area and blood flow before the second IHG stress did not return to baseline (1. vs. 2. pre-IHG stress area: 14.0 ± 4.2 vs. 13.1 ± 3.8 mm2, p = 0.01.; blood-flow: 83.9 ± 37.6 vs. 69.6 ± 19.7 ml/min, p = 0.03). Consequently, the expected changes induced by IHG were significantly attenuated, i.e. the decrease in these parameters observed during the first IHG did not occur during the secon
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