Although cardiac BOLD MRI can detect ischemic heart disease without ionizing radiation and contrast agents, its reliability remains poor due to the low sensitivity and specificity. We propose a novel strategy to overcome these barriers through: (i) an improved MRI strategy with free gas-exchange capability; (ii) repeat stimulation of heart using a validated prospective arterial CO2 targeting technique; and (iii) a statistical framework to increase the confidence measure of BOLD signal changes. Our results show that the proposed approach can be used to significantly increase the confidence in detecting myocardial BOLD response in conditions of health and disease.
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