Rapid Fire Abstracts
Mayssa Moukarzel, MSc
Researcher
McGill University Health Center, Lebanon
Elizabeth Hillier, MD, PhD
Resident Physician
McGill University Health Centre, Canada
Judy Luu, MD, PhD
Assistant Professor, Director of CMR Research
McGill, Canada
Matthias G. Friedrich, MD
Full Professor
McGill University Health Centre
Mc Gill University, Canada
Depression is associated with an increased risk of cardiovascular diseases (CVD), yet the mechanisms underlying this relationship are not fully understood (1). Oxygenation-sensitive cardiac magnetic resonance (OS-CMR), combined with vasoactive breathing maneuvers, provides a non-invasive method to assess myocardial tissue oxygenation and vascular function (2,3). Using OS-CMR, we assessed coronary vascular function in people with varying levels of depression, as measured by the Patient Health Questionnaire-9 (PHQ-9) questionnaire, a reliable and validated self-report scale (4).
Methods:
In this single-centre prospective study, we analyzed OS-CMR images performed on a 3T GE Premier scanner of 63 participants (42 with cardiovascular risk factors including obesity, hypertension, high cholesterol, and smoking but no overt CVD and 21 healthy participants) who had previously completed the PHQ-9 questionnaire. OS-CMR assessed myocardial oxygenation during a vasoactive breathing maneuver: hyperventilation (inducing vasoconstriction, reflected by a decrease in signal intensity (SI)) followed by an expiratory breath-hold (inducing vasodilation, reflected by an increase in SI). The oxygenation response plotted as an Oxygenation Cardiogram (OCG), provided several biomarkers, including mean, range, maximum, and minimum SI values across the full first (stress cardiac cycle) and last (recovery cardiac cycle) cardiac cycles of the breath-hold (Figure 1).
Global SI values were calculated using cvi42 (Circle CVI, Calgary, AB, Canada), and OCG biomarkers were extracted using a prototype MATLAB script (MathWorks, Massachusetts, USA). Participants were stratified into low depression (PHQ-9 < 5) and high depression (PHQ-9 ≥ 5) groups. Independent sample t-tests compared the different biomarkers between groups, and multivariable linear regression explored associations. Results are presented as mean ± SD.
Results:
40 participants in the low depression group (54.9±9.5 years; 48.8% females) and 23 in the high depression group (51.1±9.3 years; 52.2% females) were included in this analysis. Individuals in the high depression group had lower mean SI across OCG (7.18±1.70 vs 8.36±2.57; p=0.033) and mean Recovery Maximum (1.01±2.44 vs 1.19±3.19; p=0.016) values compared to people in the low depression group (Figure 2). Multivariable linear regression, adjusted for systolic blood pressure, heart rate, sex, age, body surface area, and cardiovascular risk factors, showed that PHQ-9 score (B = -292.61, 95% CI = -0.004, -0.001, p = 0.047) and ejection fraction (B = 2.228, 95% CI = -0.001, 0.002, p = 0.031) significantly predicted the Recovery Maximum biomarker (Table 1).
Conclusion:
Individuals with a higher level of reported depression symptoms demonstrated reduced normalized oxygenation-sensitive signal intensity, consistent with reduced myocardial oxygenation overall and a reduced coronary vascular response to a hyperventilation/breath-hold challenge. These results highlight the potential impact of depression on cardiovascular health and show the potential of breathing-enhanced OS-CMR for evaluating vascular dysfunction associated with depression.
