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Early Changes in Myocardial Microcirculation in Asymptomatic Hypercholesterolemic Subjects: As Detected by Perfusion CT

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An Erratum to this article was published on 18 March 2014

Abstract

Intramyocardial microvessels show functional changes in early stages of atherosclerosis prior to epicardial coronary artery stenosis. However, clinical CT does not have adequate spatial resolution to resolve the microvessels. To clinically detect changes in the function of the intramyocardial microcirculation, the spatial heterogeneity of the distribution of myocardial perfusion (F) and intramyocardial microcirculatory blood volume (Bv) was determined by perfusion CT. Two human subject groups were studied: (i) a “Control” group (24) with no risk factors nor evidence of coronary artery disease (CAD), and (ii) an “At-Risk” group (24) with hypercholesterolemia, but no evidence of CAD. In the perfusion CT image, a region of interest (ROI) covering the left ventricular myocardium was subdivided into multiple nested ROI (nROI) of equal size and used to compute F and Bv for each nROI. No significant differences between the groups were demonstrable in overall myocardial F, or Bv. The nROI data showed significantly increased spatial heterogeneity in the “At Risk” group when compared to “Control” subjects. This study demonstrates that subresolution distribution at the microcirculatory level can be quantified with myocardial perfusion CT and significant changes in these parameters occur in hypercholesterolemic subjects before they have developed significant changes in conventional perfusion parameters.

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Abbreviations

BPM:

Beats per minute

Bv:

Blood volume (mL cm−3)

CAD:

Coronary artery disease

CO:

Cardiac output (L min−1)

CT:

Computed tomography

F:

Myocardial perfusion (mL g−1 min−1)

HU:

Hounsfield units of CT image gray scale

HR:

Heart rate (beats per minute)

LED:

Light emitting diode

nROI:

Nested region of interest

RD:

Relative dispersion (standard deviation/mean)

ROI:

Region of interest within LV wall in CT image

TAC:

Time attenuation curves

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Acknowledgments

The authors would like to thank the following personnel. Dr. Jodie Christner and Ms. Maria Shiung; Study Coordinator, Jennifer Alkhamis; CT Techs—Lisa L. Jorgenson, Emily Sheedy, Katherine Steele, Cynthia Walfoort, Nikkole Weber; CT Nurses—Laurie Claeys, Susan Persons, Susan Inman Radenz and William Stromme; and the Division of Engineering, Aaron Treat, Ms. Renae M. Forsman, Bruce W. Gustine and Ms. Diane R. Eaker and Delories C. Darling.

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Authors and Affiliations

  1. Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA

    Thomas R. Behrenbeck & Wayne L. Miller

  2. Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Cynthia H. McCollough, Eric E. Williamson & Shuai Leng

  3. Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Timothy L. Kline & Erik L. Ritman

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  1. Thomas R. Behrenbeck
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Correspondence to Erik L. Ritman.

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Associate Editor Joel D. Stitzel oversaw the review of this article.

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Behrenbeck, T.R., McCollough, C.H., Miller, W.L. et al. Early Changes in Myocardial Microcirculation in Asymptomatic Hypercholesterolemic Subjects: As Detected by Perfusion CT. Ann Biomed Eng 42, 515–525 (2014). https://doi.org/10.1007/s10439-013-0934-z

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