RT Journal Article
SR Electronic
T1 22 Myocardial perfusion is influenced by age, gender, diabetes, myocardial fibrosis and the use of beta-blockers: a perfusion mapping study
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP A13
OP A14
DO 10.1136/heartjnl-2018-BCVI.37
VO 104
IS Suppl 5
A1 Knott, Kristopher D
A1 Camaioni, Claudia
A1 Bhuva, Anish N
A1 Brown, Louise AE
A1 Xue, Hui
A1 Manisty, Charlotte H
A1 Plein, Sven
A1 Kellman, Peter
A1 Moon, James C
YR 2018
UL http://heart.bmj.com/content/104/Suppl_5/A13.3.abstract
AB Introduction Myocardial perfusion is determined by epicardial coronary flow and the microvasculature. It is now possible to quantify perfusion non-invasively using inline quantitative perfusion mapping. We investigated patients with chest pain but unobstructed epicardial coronary arteries to determine the factors that contribute to myocardial perfusion.Methods Patients with unobstructed coronary arteries who had also undergone perfusion CMR were included. Myocardial blood flow (MBF) at stress and rest was measured on a per-segment basis and averaged to calculate a global flow. A univariate analysis and multiple linear regression analysis was performed to determine the factors influencing perfusion.Results 110 patients with a mean age of 56.6 years, 50% male were studied. There was a high prevalence of cardiovascular risk factors – hypertension 50%, dyslipidaemia 37%, smoking history 32%, type 2 diabetes 16%. Mean stress MBF was 2.53 ml/g/min, rest MBF 0.91 ml/g/min and MPR 2.91. In a multiple linear regression analysis, increasing age (p<0.01), diabetes (p<0.01), LGE (p<0.05) and beta blocker therapy (p<0.01) was associated with reduced stress MBF. The overall R2 for the model was 0.355. Rest MBF was increased in females (p<0.01) and those with higher resting heart rates (p<0.01). The R2 for the model was 0.231.Conclusion Stress MBF is influenced by age, diabetes, myocardial fibrosis and beta blocker therapy. Rest MBF is affected by gender and resting heart rate. These factors need to be taken into consideration when developing normal ranges and quantifying perfusion in clinical practice.