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Impaired coronary flow reserve evaluated by phase-contrast cine magnetic resonance imaging in patients with atrial fibrillations

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Abstract

Myocardial perfusion and perfusion reserve are diminished in patients with atrial fibrillation (AF). Phase-contrast (PC) cine magnetic resonance imaging (MRI) of the coronary sinus serves as a non-invasive means of quantifying coronary flow reserve (CFR) without any radioactive tracer. The present study aimed to evaluate the utility of PC cine MRI of the coronary sinus for assessing decreased CFR in patients with AF. We studied 362 patients with known or suspected coronary artery disease (CAD) [age 72 ± 9 years; 267 (74%) male; 90 (25%) had AF] and 20 age- and gender-matched control subjects [age 72 ± 9 years, 14 (70%) male]. Using a 1.5-T MR scanner and cardiac coils, blood flow of the coronary sinus (CBF) was quantified by PC cine MRI. CFR was calculated as CBF during adenosine triphosphate infusion divided by CBF at rest. CFR was significantly lower in patients with AF than in those without AF among all patients (n = 362) (2.45 ± 0.42 vs. 2.71 ± 0.58, p < 0.001), in patients with known CAD (n = 155) (2.40 ± 0.46 vs. 2.72 ± 0.58, p = 0.002), and in those with suspected CAD (n = 207) (2.49 ± 0.40 vs. 2.72 ± 0.59, p = 0.007). Significant differences in CFR were found between controls and patients without AF (3.12 ± 0.52 vs. 2.71 ± 0.58, p < 0.001). AF was independently associated with CFR in both known CAD patients [β = − 0.248, 95% confidence interval (CI): − 0.561 to − 0.119, p = 0.003) and suspected CAD patients (β =  − 0.154, 95% CI − 0.353 to − 0.034, p = 0.018). The presence of AF was related to impaired CFR in both known and suspected CAD patients. PC cine MRI of the coronary sinus can be useful for detecting impaired CFR in patients with AF.

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Abbreviations

AF:

Atrial fibrillation

CBF:

Coronary sinus blood flow

CFR:

Coronary flow reserve

CI:

Confidence interval

EDVI:

End-diastolic volume index

ESVI:

End-systolic volume index

EF:

Ejection fraction

ICC:

Intraclass correlation coefficient

LV:

Left ventricular

MR:

Magnetic resonance

PC:

Phase contrast

SD:

Standard deviation

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Authors and Affiliations

  1. Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan

    Yoichiro Sugimoto, Shingo Kato & Kazuki Fukui

  2. Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan

    Tae Iwasawa

  3. Department of Cardiology, IMS Miyoshi General Hospital, Miyoshi, Saitama, Japan

    Yoichiro Sugimoto

  4. Department of Diagnostic Radiology, Yokohama City University, Yokohama, Japan

    Daisuke Utsunomiya

  5. Department of Cardiology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan

    Kazuo Kimura

  6. Department of Medical Science and Cardiorenal Medicine, Yokohama City University, Yokohama, Kanagawa, Japan

    Kouichi Tamura

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  1. Yoichiro Sugimoto
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  2. Shingo Kato
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  3. Kazuki Fukui
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  5. Daisuke Utsunomiya
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Correspondence to Shingo Kato.

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Sugimoto, Y., Kato, S., Fukui, K. et al. Impaired coronary flow reserve evaluated by phase-contrast cine magnetic resonance imaging in patients with atrial fibrillations. Heart Vessels 36, 775–781 (2021). https://doi.org/10.1007/s00380-020-01759-x

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  • DOI: https://doi.org/10.1007/s00380-020-01759-x

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