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Abstract #4484

High resolution quantitative spiral CMR perfusion imaging demonstrates a reduced endocardial to epicardial perfusion gradient and myocardial flow reserve in patients with microvascular disease

Michael Salerno 1,2 , Yang Yang 3 , Peter Shaw 4 , Angela Taylor 4 , Craig Meyer 3 , Fred Epstein 3 , and Christopher Kramer 4,5

1 Medicine, Cardiology, University of Virginia, Charlottesville, VA, United States, 2 Radiology, University of Virginia, Charlottesville, VA, United States, 3 Biomedical Engineering, University of Virginia, VA, United States, 4 Medicine, Cardiology, University of Virginia, VA, United States, 5 Radiology, University of Virginia, VA, United States

Patients with non-obstructive coronary artery disease may have abnormal myocardial perfusion reserve (MPR) resulting from microvascular disease (MVD). Reduced MPR as demonstrated by PET is a significant predictor of cardiac death. CMR has the unique ability to quantify transmural differences in perfusion given its high spatial resolution providing new insights into MVD. We developed a high resolution (1.5mm) quantitative spiral perfusion pulse sequence and performed vasodilator stress in patients with a high likelihood of MVD. We demonstrate an abnormal stress endocardial to epicardial perfusion gradient as well as abnormal MPR in these patients.

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