Improvement of myocardial perfusion reserve early after coronary intervention: Assessment with cardiac magnetic resonance imaging

OBJECTIVES The purpose of this study was to determine the potential value o f magnetic resonance myocardial perfusion in the follow up of patients afte r coronary intervention. BACKGROUND In some patients a residual impairment of myocardial perfusion r eserve (MPR) early after successful coronary intervention has been observed . In this study we evaluated an MPR index before and after intervention Wit h magnetic resonance. METHODS Thirty-five patients with single- and multivessel coronary artery d isease were studied before and 24 h after intervention. The signal intensit y time curves of the first pass of a gadolinium-diethylene triamine pentace tic acid bolus injected via a central vein catheter were evaluated before a nd after dipyridamole infusion. The upslope was determined using a linear f it. Myocardial perfusion reserve index was estimated from the alterations o f the upslope. RESULTS The MPR index in segments perfused by the stenotic artery was signi ficantly lower than in the control segments (1.07 +/- 0.24 vs. 2.18 +/- 0.3 5, p < 0.001) and improved significantly after intervention (1.89 +/- 0.39, p < 0.001) but did not normalize completely (p < 0.01). After intervention the MPR index remained significantly lower in the balloon percutaneous tra nsluminal coronary angioplasty group (1.72 +/- 0.38; n = 13) in comparison with the stent group (1.99 +/- 0.36, n = 18, p < 0.05). In the stent group a complete normalization of the MPR index was found 24 h after stenting. CONCLUSIONS Magnetic resonance perfusion measurements allow a reliable asse ssment of MPR index. An improvement of MPR index can be observed after coro nary intervention, which is more pronounced after stenting. Magnetic resona nce perfusion measurements allow the assessment and may be useful for the f ollow-up of patients with coronary artery disease after coronary interventi on. (C) 2000 by the American College of Cardiology.