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Science Sessions

Science Session 5: Oxygenation and Metabolic Imaging with CMR

Cardiac MRI Quantitative Susceptibility Oxygen Mapping Predicts Invasively Derived Cardiac Index

Friday, January 31, 2025
2:20 PM – 2:30 PM East Coast USA Time
Location: Blue Room
Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that affects multiple organs, including the heart. Although pericarditis is the most widely recognized cardiac manifestation of SLE, chronic inflammation and corticosteroid exposure can lead to accelerated development of coronary artery disease. This study aimed to assess quantitative stress myocardial perfusion in patients with SLE compared to healthy controls.

Methods: Female patients with SLE underwent in-line quantitative adenosine stress myocardial perfusion mapping cardiovascular magnetic resonance imaging (Qperf-CMR) at 3T. Healthy volunteers underwent Qperf-CMR only at either 1.5T or 3T.

Results: There was no difference in quantitative stress myocardial perfusion between healthy controls at 1.5T and 3T (n=55, 3.6±0.7 vs n=23, 3.6±0.7 ml/min/g, p=0.86). Compared to age-matched female healthy controls (n=25, age 45±15 years), female patients with SLE (n=23, aged 47±10 years) had lower quantitative stress myocardial perfusion (2.5±0.6 vs 3.7±0.6 ml/min/g, p< 0.001, Figure 1).

Conclusion:

Patients with SLE show reduced stress myocardial perfusion consistent with some degree of coronary microvascular dysfunction. These findings support the use of quantitative stress myocardial perfusion CMR for assessment of coronary microvascular dysfunction in patients, potentially guiding targeted cardiovascular risk management.

Figure 1. Comparison of quantitative stress myocardial perfusion between controls and patients with SLE.

Figure 1. Two representative cases from pulmonary hypertension patients showing from left to right columns (a, e) combined gradient echo magnitude from NAV QSM, (b, f) combined magnitude from spiral QSM, (c, g) NAV QSM and (d, h) spiral QSM. The estimated differential blood oxygen saturation between the right/left heart (ΔSaO2) in subject #1 (first row) is 34% from NAV QSM and 33% from spiral QSM versus 36% from right heart catheterization (RHC). ΔSaO2 estimation in subject #2 (second row) is 28% from NAV QSM and 33% from spiral QSM versus 28% from RHC.

Scatter plots showing the relationship between cardiac index (L/min/m²) and various non-invasive cardiac magnetic resonance parameters.