Clinical Validation of a Wideband Perfusion Pulse Sequence: Myocardial Blood Flow Quantification in Patients with a CIED during stress and at rest

Motivation: Although wideband perfusion sequences have shown effectiveness in quantifying myocardial-blood-flow (MBF) at rest in patients with cardiac-implantable-electronic-devices (CIEDs), their utility during vasodilator stress remains unproven. Goal(s): To clinically validate whether stress-rest MBF quantification derived from a 6-fold-accelerated wideband perfusion sequence is able to detect myocardial ischemia in patients with implantable-cardioverter-defibrillators (ICDs). Approach: We enrolled 21 patients with ICDs and 11 ICD simulated control patients with no coronary-artery-disease (CAD) using the wideband perfusion sequence during adenosine stress and at rest, calculated and compared stress-rest MBF and myocardial-perfusion-reserve (MPR) values. Results: Stress MBF and MPR values were significantly lower in patients with ICDs than controls. Impact: This study validates that a 6-fold accelerated wideband perfusion pulse sequence produces meaningful stress MBF and MPR measurements for detecting myocardial ischemia in patients with ICDs.