Adenosine stress CMR perfusion imaging of the temporal evolution of perfusion defects in a porcine model of progressive obstructive coronary artery occlusion.
Adenosine stress CMR perfusion imaging of the temporal evolution of perfusion defects in a porcine model of progressive obstructive coronary artery occlusion.
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腺苷应激 CMR 灌注成像显示渐进性阻塞性冠状动脉闭塞猪模型中灌注缺陷的时间演变。
DOI：
10.1002/nbm.4136
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发表时间：
2019
影响因子：
2.9
通讯作者：
Salerno,M
中科院分区：
文献类型：
--
作者：
VanHouten,M;Yang,Y;Hauser,A;Glover,DK;Gan,L-M;Yeager,M;Salerno,M
腺苷负荷CMR灌注成像可以定量冠状动脉疾病（CAD）的绝对灌注和心肌灌注储备（MPR），具有比正电子发射断层扫描更高的空间分辨率，这是临床上唯一可用的定量心肌灌注成像技术。虽然CAD的猪模型对于研究慢性CAD中的灌注异常是极好的，但迄今为止，使用定量灌注进行评价的研究数量有限。因此，我们开发了一种腺苷应激CMR方案，以评估进行性阻塞性CAD猪模型中灌注缺损的时间演变。10只尤卡坦小型猪在左回旋支（LCX）周围放置Ameroid封堵器，以诱导进行性慢性冠状动脉阻塞。四只动物进行了血流动力学剂量范围实验，以确定诱导最大充血的腺苷剂量。每只动物都进行了CMR检查，包括基线和第1、3和6周的应激/静息螺旋定量灌注成像。晚期钆增强图像确定是否存在心肌梗死（如果存在）。使用费米去卷积生成像素定量灌注图。采用重复混合测量模型对结果进行统计学分析，以阻断动物之间的生理变化。5只动物在3周内发生心肌梗死，而3只发生缺血而无梗死。灌注缺损位于LCX灌注区的下外侧心肌。远端节段的负荷灌注值高于梗死和缺血节段（P< 0.01）。远端节段MPR值明显大于梗死和缺血节段（P< 0.01）。虽然所有部分的MPR均下降，但偏远地区的MPR在第六周时恢复。我们开发了一个渐进式CAD模型，并评估了定量灌注缺陷发展的时间演变。该模型将作为了解慢性闭塞性CAD灌注异常发展的平台。
Adenosine stress CMR perfusion imaging can quantify absolute perfusion and myocardial perfusion reserve (MPR) in coronary artery disease (CAD) with higher spatial resolution than positron emission tomography, the only clinically available technique for quantitative myocardial perfusion imaging. While porcine models of CAD are excellent for studying perfusion abnormalities in chronic CAD, to date there are a limited number of studies that use quantitative perfusion for evaluation. Therefore, we developed an adenosine stress CMR protocol to evaluate the temporal evolution of perfusion defects in a porcine model of progressive obstructive CAD. 10 Yucatan minipigs underwent placement of an ameroid occluder around the left circumflex artery (LCX) to induce a progressive chronic coronary obstruction. Four animals underwent a hemodynamic dose range experiment to determine the adenosine dose inducing maximal hyperemia. Each animal had a CMR examination, including stress/rest spiral quantitative perfusion imaging at baseline and 1, 3, and 6 weeks. Late gadolinium enhancement images determined the presence of myocardial infarction, if any existed. Pixelwise quantitative perfusion maps were generated using Fermi deconvolution. The results were statistically analyzed with a repeated mixed measures model to block for physiological variation between the animals. Five animals developed myocardial infarction by 3 weeks, while three developed ischemia without an infarction. The perfusion defects were located in the inferolateral myocardium in the perfusion territory of the LCX. Stress perfusion values were higher in remote segments than both the infarcted and ischemic segments (p< 0.01). MPR values were significantly greater in the remote segments than infarcted and ischemic segments (p< 0.01). While the MPR decreased in all segments, the MPR recovered by the sixth week in the remote regions. We developed a model of progressive CAD and evaluated the temporal evolution of the development of quantitative perfusion defects. This model will serve as a platform for understanding the development of perfusion abnormalities in chronic occlusive CAD.
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影响因子：
29.4
作者：
Paul H. Guth;Esther Smith
通讯作者：
Esther Smith
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影响因子：
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影响因子：
29.4
作者：
P. Heitmann;A. M. Jungreis;H. Janowitz
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影响因子：
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作者：
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