Association of cardiovascular risk factors on myocardial perfusion and fibrosis in asymptomatic individuals: cardiac magnetic resonance study

Abstract

Background

Myocardial perfusion reserve index (MPRI) and extracellular volume fraction (ECV) on cardiac magnetic resonance (CMR) are known to quantify coronary microvascular dysfunction and myocardial fibrosis, respectively.

Purpose

To demonstrate that cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, and smoking are correlated with MPRI and ECV on CMR in asymptomatic individuals.

Material and Methods

Between October 2013 and July 2014, 196 individuals underwent CMR. After excluding those with chest pain, arrhythmia, and obstructive coronary artery disease, participants were divided into five groups: those without risk factor (n = 26) and those with one (n = 43), two (n = 35), three (n = 24), or four (n = 6) risk factors. MPRI and ECV were obtained on perfusion CMR and pre- and post-T1 mapping, respectively.

Results

A total of 134 asymptomatic individuals (109 men, 25 women; mean age = 54.4 ± 7.08 years; body mass index [BMI] = 24.96 ± 2.76 kg/m²; Framingham risk score [FRS] = 7.71 ± 5.21) were included. The Jonckheere-Terpstra test demonstrated trends of increasing BMI, FRS, and left ventricular mass index (all P values < 0.001), but decreasing MPRI (P = 0.001) with increasing numbers of risk factors. Stepwise multiple linear regression demonstrated that an increasing number of cardiovascular risk factors was an independent predictor of MPRI (P = 0.001). However, there was no significant association between the number of risk factors and ECV (P = 0.99).

Conclusion

We demonstrated that an increasing number of cardiovascular risk factors is significantly associated with reduced MPRI, but not with ECV on CMR.

Keywords

Cardiac magnetic resonance myocardial perfusion reserve index extracellular volume fraction cardiovascular risk factor asymptomatic

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