Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Ischemic Heart Disease
Absolute Myocardial Blood Flow After Elective Percutaneous Coronary Intervention Evaluated on Phase-Contrast Cine Cardiovascular Magnetic Resonance Imaging
Rikuta Hamaya, Akinori Sugano, Yoshihisa Kanaji, Tadashi Fukuda, Yoshinori Kanno, Taishi Yonetsu, Eisuke Usui, Masahiro Hoshino, Masahiro Hada, Hiroaki Ohya, Yohei Sumino, Haruhito Yuki, Tadashi Murai, Tetsumin Lee, Tsunekazu Kakuta
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Keywords: Coronary flow reserve, Coronary sinus flow, Fractional flow reserve, Phase-contrast cine cardiovascular magnetic resonance imaging, Percutaneous coronary intervention
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2018 Volume 82 Issue 7 Pages 1858-1865

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Abstract

Background:Few studies have documented changes in myocardial blood flow (MBF) after percutaneous coronary intervention (PCI). Phase-contrast cine cardiovascular MRI (PC-CCMR) of the coronary sinus (CS) is a promising approach to quantify MBF. The aim of this study was to quantify CS flow (CSF) on PC-CCMR as a measure of volumetric MBF before and after elective PCI.

Methods and Results:We prospectively studied 34 patients with stable angina undergoing elective PCI for a single de novo lesion. Breath-hold PC-CCMR of CS was acquired to assess CSF and coronary flow reserve (CFR) at rest and during maximum hyperemia both before and after PCI (median, 3 days before PCI and 10 days after PCI, respectively). In total, hyperemic CSF increased significantly after PCI (before PCI, median, 2.3 mL/min/g [IQR, 1.5–3.2 mL/min/g] after PCI, 3.0 [1.8–3.7] mL/min/g), although 13 patients (38.2%) had a decrease despite successful PCI and fractional flow reserve (FFR) improvement. Global CFR also significantly increased from a median of 2.5 (IQR, 1.5–3.5) to 3.4 (IQR, 2.1–4.2), whereas 12 patients had decreased CFR after PCI. Pre-PCI hyperemic CSF was the only independent factor of change in CSF following PCI.

Conclusions:Serial PC-CCMR of CS as a measure of change in absolute MBF is feasible. Uncomplicated PCI does not necessarily increase hyperemic global MBF, despite regional FFR improvement.

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© 2018 THE JAPANESE CIRCULATION SOCIETY
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