Abstract 15263: Myocardial Perfusion Reserve is Impaired in Patients with Chronic Obstructive Pulmonary Disease: a Quantitative Myocardial Perfusion MRI Study
Background: Chronic obstructive pulmonary disease (COPD) is associated with atherosclerosis and cardiovascular disease. However, limited data is available regarding the association between COPD and myocardial perfusion reserve (MPR), a modality which reflects microvascular function. The purpose of this study was to determine whether airflow limitation affected MPR in asymptomatic subjects without coronary artery disease (CAD) by using quantitative myocardial perfusion magnetic resonance imaging (MRI).
Methods: A retrospective analysis was performed on 60 subjects without CAD: COPD patients (n=20), control smokers (n=20) and control never-smokers (n=20). Normal LV wall motion, no regional myocardial ischemia and no myocardial scar on MRI were observed in all patients. Myocardial perfusion MRI was acquired with a dual bolus method for saturation correction. Myocardial blood flow (MBF) was quantified in 16 myocardial segments by using a Patlak plot method. MPR was calculated as stress MBF divided by rest MBF.
Results: There were no significant differences in the rest MBF among COPD patients, control smokers and control never-smokers (1.27 ± 0.58 vs. 1.05 ± 0.44 vs. 1.02 ± 0.63 mL/min/g, = 0.36). However, the mean MPR was significantly lower in COPD patients than in control smokers and control never-smokers (2.26 ± 1.03, 3.06 ± 1.28, and 3.74 ± 1.27, respectively, P < 0.001). No significant differences were found in age, gender, systolic blood pressure, fasting glucose, low-density lipoprotein and C-reactive protein (CRP) levels among the three groups. There is a significant correlation between the MPR and log CRP with an R value of 0.56 (P < 0.001). Multi-variate analysis revealed impaired MPR is associated with the presence of COPD (P=0.002) and log CRP (P=0.003), independent of age, BMI, Brinkman index, systolic blood pressure, fasting glucose and low-density lipoprotein levels.
Conclusion: MPR was impaired in COPD patients without CAD and associated with CRP levels. Thus, coronary microvascular function may be impaired in patients with COPD through systemic inflammation.
- © 2011 by American Heart Association, Inc.