Assessment of the relationship between myocardial microstructure and microvascular perfusion using cardiac magnetic resonance: novel imaging biomarker

Summary

The spatial interaction between the vessels and the arrangement of the cardiomyocytes is crucial to maintain an efficient delivery of oxygen to the cells. Current imaging techniques allow for the assessment of myocardial blood flow as indirect measurement of perfusion but lack to quantify the actual efficiency of oxygen delivery in the context of the 3D myocardial architecture.

Knowledge of this interrelationship is particularly crucial in cardiac disease such as hypertrophic cardiomyopathy (HCM), which is characterized by cardiomyocytes disarray and myocardial perfusion abnormalities due to dysfunction of the microcirculation. Recent technical developments in diffusion-weighted Magnetic Resonance Imaging could potentially allow for investigating the perfusion system in relation to cardiomyocyte architecture in more detail and provide new biomarkers of cardiac disease. This proposal aims to establish a novel diffusion weighted technique (i.e. Intra-Voxel Incoherent Motion – IVIM) to assess myocardial perfusion in relation to the myocardial micro-architecture. We propose to validate the technique on the isolated perfused rat heart; we will then establish baseline parameters and reproducibility in volunteers. We finally will investigate the clinical utility of the IVIM biomarkers in HCM patients, although novel IVIM biomarkers may also allow for more accurate risk stratification in other cardiac diseases.

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