In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.


The free consultation period for this content is over.

It is now only available year-round to EACVI Silver Members, Fellows of the ESC and Young combined Members

Myocardial and cerebral oxygenation deficits in heart failure patients - a multi-parametric study

Session Moderated ePosters session 4: CMR values and flow

Speaker Elizabeth Hillier

Congress : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cross-Modality and Multi-Modality Imaging Topics
  • Session type : Moderated Posters
  • FP Number : 285

Authors : E Hillier (Montreal,CA), T Hafyane (Montreal,CA), M G Friedrich (Montreal,CA)

Authors:
E Hillier1 , T Hafyane2 , M G Friedrich1 , 1McGill University Health Centre - Montreal - Canada , 2Mcgill University - Montreal - Canada ,

On behalf: MUHC CMR Group

Citation:
European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii216

Introduction: Cognitive decline is a known co-morbidity of Heart Failure. Many different pathophysiological mechanisms have been suggested as etiologies underlying the development of cognitive impairment such as cerebral hypoperfusion as a result of reduced cardiac output, decreased cerebrovascular reactivity, microvascular dysfunction, arterial hypertension, and increased chronic proinflammatory response. In compromised vasculature, increased oxygen demand without an accompanying increase in blood flow would result in increased levels of deoxyhemoglobin and an SI decrease, signalling microvascular dysfunction.

Purpose: Assess the myocardial and cerebral oxygenation reserve deficits utilizing the blood oxygen level dependent properties of Oxygenation-Sensitive MRI (OS-MRI) in heart failure patients.

Methods: Twelve heart failure patients (mean age 64±9 years; 36% female) and fourteen age-matched healthy volunteers (mean age 56±5 years; 64% female) underwent a CMR on a clinical 3T scanner (Skyra, Siemens, Erlangen, Germany). CMR functional parameters were obtained from standard SSFP cine images cine biplanar long-axis images. OS CMR images were obtained in a basal and mid-ventricular short-axis slice. The global Myocardial Oxygenation Reserve (MORE) was obtained from oxygenation sensitive SSFP short-axis cine images were acquired at resting baseline and continuously during a voluntary maximal breath-hold following a 60s period of hyperventilation. The cerebral BOLD images were obtained in the axial plane covering the full cerebrum. The global Cerebral Oxygenation Reserve (CORE) was obtained from subtraction images delineating the global signal intensity differences obtained on BOLD images in the grey matter of the brain.

Results: Heart failure patients (LVEF=40.98+/-14.18%) had a significantly lower left ventricular ejection fraction (LVEF) when compared to healthy controls (LVEF=69.46+/-6.79%) (p<0001). The percent-change in signal intensity in brain grey matter (CORE) and the global myocardium (MORE) after breathing maneuvers were significantly reduced in patients when compared to healthy controls (mean CORE 0.29+/-0.63 vs. 1.083+/-0.5047, p=0.0021, mean MORE 0.2497+/-3.495 vs. 4.451+/-4.15, p=0.0131) (Fig 1). There is a significant correlation between CORE and LVEF in heart failure patients with a Pearson correlation coefficient r=0.642, and a coefficient of determination r^2=0.4123, p=-0.032 (Fig 2).

Conclusion: The significant reduction of both cerebral and myocardial oxygenation reserves in heart failure patients when compared to healthy control subjects indicated that microvascular dysfunction of both the cerebrum and myocardium are present in heart failure patients. The presence of a significant correlation between LVEF and CORE suggests that microvascular dysfunction in the brain may be a result of chronic hypoperfusion.

The free consultation period for this content is over.

It is now only available year-round to EACVI Silver Members, Fellows of the ESC and Young combined Members



Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are