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Extracellular volume fraction in coronary chronic total occlusion patients

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Abstract

(1) To assess extracellular volume fraction (ECV) and regional systolic function in patients presenting with coronary chronic total occlusion (CTO) in areas without significant late gadolinium enhancement (LGE), and (2) to investigate the correlation between angiography collateral flow and ECV in territories supplied by CTO vessels. A total of 50 angiographically documented CTO patients and 15 age- and sex-matched normal controls were recruited to the study. Myocardial ECV, was calculated in infarcted, global non-infarcted and the entire myocardium respectively. Segmental ECV was calculated from myocardial segments within the perfusion territory of a CTO vessel. The global and regional systolic function was evaluated using ejection fraction and percent systolic thickening. ECVs in global myocardium and global non-infarcted myocardium were significantly elevated in comparison with that in controls (29.1 ± 4.2 % and 26.6 ± 2.6 % vs. 23.3 ± 2.0 %, all P < 0.005). Global ECV significantly correlated with LV ejection fraction (r = −0.56, P < 0.001) and ECV inversely correlated with systolic thickening in global non-infarcted myocardium (r = −0.31, P < 0.05). The lower segmental ECV was associated with the presence of well-developed collaterals (P = 0.004), and multivariate binary logistic analysis demonstrated that mean segmental ECV and course of disease were the independent discriminator of collateral flow with overall diagnostic accuracy of 74.4 %. In patients with CTO, ECV is found to be increased beyond that observed with LGE, and correlates with LV regional wall motion abnormality, which appears to reflect diffuse myocardial fibrosis. Mean segmental ECV value, combined with course of disease, may serve as good predictors of collateral flow.

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Abbreviations

ECV:

Extracellular volume fraction

CTO:

Chronic total occlusion

LGE:

Late gadolinium enhancement

DMF:

Diffuse myocardial fibrosis

CMR:

Cardiovascular magnetic resonance

MI:

Myocardial infarction

MYO:

Myocardium

EF:

Ejection fraction

MOLLI:

Modified Look-Locker Inversion Recovery

TIMI:

Thrombolysis in myocardial infarction grade

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Acknowledgments

This work was supported by the National Natural Science Foundation of China (Grant Number 81201070) and Fudan University Foundation for young teachers to improve scientific research ability (Grant Number 20520133486).

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Radiology, Zhongshan Hospital, Fudan University, 180#, Fenglin Road, Shanghai, China

    Yin Yin Chen, Shan Yang, Hong Yun, Meng Su Zeng & Hang Jin

  2. Department of Medical Imaging, Shanghai Medical School, Fudan University and Shanghai Institute of Medical Imaging, 180#, Fenglin Road, Shanghai, China

    Yin Yin Chen, Shan Yang, Hong Yun, Meng Su Zeng & Hang Jin

  3. Department of Radiology, The First Affiliated Hospital of Soochow University, 188# Shizi street, Suzhou, China

    Yin Yin Chen, Wei Guo Zhang & Liang Guo

  4. Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Hang Jin

  5. Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China

    Sheng Ming Deng

  6. Siemens Shenzhen Magnetic Resonance (C.F.), Shenzhen, China

    Cai Xia Fu

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  1. Yin Yin Chen
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Correspondence to Meng Su Zeng, Hang Jin or Liang Guo.

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Chen, Y.Y., Zhang, W.G., Yang, S. et al. Extracellular volume fraction in coronary chronic total occlusion patients. Int J Cardiovasc Imaging 31, 1211–1221 (2015). https://doi.org/10.1007/s10554-015-0680-4

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  • DOI: https://doi.org/10.1007/s10554-015-0680-4

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