Clinical physiology and functional imaging · 2026
Myocardial perfusion reserve is low in heart transplant patients and is related to exercise capacity.
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Dimovski Kristian, Gjesdal Grunde, Steding-Ehrenborg Katarina, Jablonowski Robert, Xue Hui, Kellman Peter, Braun Oscar, Arheden Håkan, Engblom Henrik
Аннотация
AIMS: Heart transplant (HTx) patients are known to be at risk of coronary microvascular dysfunction as well as having decreased exercise capacity. The aim of this study was to investigate if microvascular function in HTx patients differs from healthy controls and is related to objective measures of exercise capacity.
METHODS AND RESULTS: Twenty-nine HTx patients (51 ± 15 years, 34% women) and 26 healthy controls (57 ± 10 years, 38% women) underwent CMR. Quantitative myocardial perfusion maps were acquired using single-bolus (0.05 mmol/kg), dual-sequence perfusion mapping at adenosine stress and at rest. In addition, all HTx patients performed a maximal cardiopulmonary exercise test with gas-exchange analysis for objective assessment of exercise capacity. Heart transplant patients had lower stress myocardial perfusion (2.9 ± 0.8 vs 3.4 ± 0.8, p = 0.03) and lower myocardial perfusion reserve (MPR) (2.7 ± 0.7 vs 3.8 ± 1.2, p < 0.001) compared to healthy controls. Furthermore, MPR in HTx patients was correlated with maximal workload (R2 = 0.25, p = 0.016), O2 pulse (R2 = 0.21, p = 0.026), peak O2 consumption (VO2 peak) (R2 = 0.25, p = 0.015) and O2 consumption (VO2) at the anaerobic threshold (AT) (R2 = 0.27, p = 0.011).
CONCLUSION: Microvascular function as assessed by quantitative CMR perfusion mapping is lower in HTx patients than in healthy controls and is partly related to objective measures of exercise capacity.
METHODS AND RESULTS: Twenty-nine HTx patients (51 ± 15 years, 34% women) and 26 healthy controls (57 ± 10 years, 38% women) underwent CMR. Quantitative myocardial perfusion maps were acquired using single-bolus (0.05 mmol/kg), dual-sequence perfusion mapping at adenosine stress and at rest. In addition, all HTx patients performed a maximal cardiopulmonary exercise test with gas-exchange analysis for objective assessment of exercise capacity. Heart transplant patients had lower stress myocardial perfusion (2.9 ± 0.8 vs 3.4 ± 0.8, p = 0.03) and lower myocardial perfusion reserve (MPR) (2.7 ± 0.7 vs 3.8 ± 1.2, p < 0.001) compared to healthy controls. Furthermore, MPR in HTx patients was correlated with maximal workload (R2 = 0.25, p = 0.016), O2 pulse (R2 = 0.21, p = 0.026), peak O2 consumption (VO2 peak) (R2 = 0.25, p = 0.015) and O2 consumption (VO2) at the anaerobic threshold (AT) (R2 = 0.27, p = 0.011).
CONCLUSION: Microvascular function as assessed by quantitative CMR perfusion mapping is lower in HTx patients than in healthy controls and is partly related to objective measures of exercise capacity.