Myocardial viability under various ischemic burdens in chronic total occlusions: A stress-cardiac magnetic resonance study

• Published in: Meta-radiology 2024-09, Vol.2 (3), p.100097, Article 100097
• Main Authors: Li, Kang, Zhao, Wenjin, Liu, Hongduan, Zhang, Jiamin, He, Daijun, Luo, Meichen, Guo, Hu, Zhou, Xiaoyue, Chen, Zhu, Zeng, Mu
• Format: Article
• Language: English
• Subjects: Chronic total occlusion; Late gadolinium enhancement; Myocardial ischemic burden; Myocardial viability; Stress cardiac magnetic resonance
• ISSN: 2950-1628; 2950-1628
• DOI: 10.1016/j.metrad.2024.100097

Objectives: This study aimed to analyze each myocardial segment's ischemic burden, scarring, function, and viability by late gadolinium enhancement (LGE) imaging and stress-MRI using adenosine. Materials and methods: Semi-quantitative and qualitative parameters of myocardial segments were obtained by stress-MRI. Moreover, segments without perfusion defect were defined as the no ischemic group, segments with a perfusion defect of ≤50% were defined as a low ischemic burden group, and segments with a perfusion defect of >50% were defined as a high ischemic burden group. “Segmental wall thickening (SWT)” was defined as the absolute difference between the end-diastolic and end-systolic wall thickness. Finally, viability was defined by dysfunctional myocardium (50%. Among the different ischemic burden groups, there were significant differences in LGE volume (p ​ ​0.05). Conclusions: Stress MRI parameters can accurately and detailly assess myocardial viability and function, so multi-parameter joint assessment of CTO patients by stress MRI may help in treatment decisions.