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Feasibility of dynamic CT-based adenosine stress myocardial perfusion imaging to detect and differentiate ischemic and infarcted myocardium in an large experimental porcine animal model

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Abstract

The purpose of the study is feasibility of dynamic CT perfusion imaging to detect and differentiate ischemic and infarcted myocardium in a large porcine model. 12 Country pigs completed either implantation of a 75 % luminal coronary stenosis in the left anterior descending coronary artery simulating ischemia or balloon-occlusion inducing infarction. Dynamic CT-perfusion imaging (100 kV, 300 mAs), fluorescent microspheres, and histopathology were performed in all models. CT based myocardial blood flow (MBFCT), blood volume (MBVCT) and transit constant (Ktrans), as well as microsphere’s based myocardial blood flow (MBFMic) were derived for each myocardial segment. According to histopathology or microsphere measurements, 20 myocardial segments were classified as infarcted and 23 were ischemic (12 and 14 %, respectively). Across all perfusion states, MBFCT strongly predicted MBFMic (β 0.88 ± 0.12, p < 0.0001). MBFCT, MBVCT, and Ktrans were significantly lower in ischemic/infarcted when compared to reference myocardium (all p < 0.01). Relative differences of all CT parameters between affected and non-affected myocardium were higher for infarcted when compared to ischemic segments under rest (48.4 vs. 22.6 % and 46.1 vs. 22.9 % for MBFCT, MBVCT, respectively). Under stress, MBFCT was significantly lower in infarcted than in ischemic myocardium (67.8 ± 26 vs. 88.2 ± 22 ml/100 ml/min, p = 0.002). In a large animal model, CT-derived parameters of myocardial perfusion may enable detection and differentiation of ischemic and infarcted myocardium.

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Acknowledgments

This study supported by an unrestricted grant by Bayer Healthcare, Berlin, Germany and by the DZHK (German Centre for Cardiovascular Research) and by the BMBF (German Ministry of Education and Research).

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Authors and Affiliations

  1. Department of Clinical Radiology, Klinikum Grosshadern, Ludwig-Maximilians University, Marchioninistrasse 15, 81377, Munich, Germany

    Fabian Bamberg, Roy P. Marcus, Elisabeth Baloch, Kristof Hildebrandt, Florian Schwarz, Holger Hetterich, Torleif A. Sandner, Maximilian F. Reiser, Daniel Theisen & Konstantin Nikolaou

  2. Department of Cardiology, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany

    Rabea Hinkel & Christian Kupatt

  3. Cardiac MR PET CT Program, Division of Cardiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Fabian Bamberg, Christopher L. Schlett & Udo Hoffmann

  4. DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany

    Fabian Bamberg, Rabea Hinkel, Florian Schwarz, Holger Hetterich, Christian Kupatt, Maximilian F. Reiser, Daniel Theisen & Konstantin Nikolaou

  5. Heart Center Bogenhausen, Munich Municipal Hospital Group, Munich, Germany

    Ullrich Ebersberger

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  1. Fabian Bamberg
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Correspondence to Fabian Bamberg.

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Bamberg, F., Hinkel, R., Marcus, R.P. et al. Feasibility of dynamic CT-based adenosine stress myocardial perfusion imaging to detect and differentiate ischemic and infarcted myocardium in an large experimental porcine animal model. Int J Cardiovasc Imaging 30, 803–812 (2014). https://doi.org/10.1007/s10554-014-0390-3

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  • DOI: https://doi.org/10.1007/s10554-014-0390-3

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