# Tailoring Stress Cardiac MRI for Women with Ischemic Heart Disease

> **NIH VA I01** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2022 · —

## Abstract

PROJECT ABSTRACT
Chronic ischemic heart disease (IHD) is a $10.4-billion-dollar problem that is responsible for 45.1% of deaths
attributable to cardiovascular disease. Compared to men, women have a different spectrum of IHD. Current
diagnostic tools follow a one-size-fits-all model and are designed to detect a male pattern of IHD. Issues such
as breast tissue, obesity, and lung disease render easily accessible tools such as ultrasound or nuclear
SPECT imaging more limiting for women. Ischemia with no obstructive coronary disease is more common in
women compared to men; symptomatic women face higher rates of major cardiac events than asymptomatic
women. Therefore, accurate non-invasive tools that enable characterization of the entire spectrum of IHD and
its correlative ischemic burden are crucial for clinical management of women with ischemic symptoms. Invasive
interventions are without risks and lack of therapeutics contributes to disability. Myocardial ischemia occurs
when there is an imbalance between metabolic demand and blood supply. Although tissue blood supply is
affected by both myocardial blood flow (MBF) and myocardial blood volume (MBV), current stress perfusion
strategies focus on measuring deficits in MBF, which alone may not reflect all aspects of myocardial ischemia.
To better reflect the ischemic burden, we propose an MBV-based, whole-heart, gadolinium-free, non-
nephrotoxic, ferumoxytol contrast-enhanced, cardiac magnetic resonance imaging (MRI) stress testing
approach that will detect inducible ischemia. We build upon our experience in ferumoxytol-enhanced MRI and
add rigor by testing our strategy in pre-clinical models of ischemia; we efficiently translate our approach to the
clinic by validating the technique in women with IHD, some of whom require ferumoxytol for therapeutic
purposes. Because 2 billion people worldwide have iron deficiency, the dual use of ferumoxytol as a diagnostic
and therapeutic agent in the context of stress testing represents one approach to tailoring stress cardiac MRI
for women who are frequently iron deficient. Successful completion of our project would result in a gadolinium-
free, ferumoxytol-enhanced MRI stress testing approach that can reliably differentiate between normal vs
ischemic myocardial tissue and would establish a foundation for development of myocardial stress testing
approaches that enable interrogation of both epicardial and microvascular IHD.

## Key facts

- **NIH application ID:** 10426232
- **Project number:** 5I01CX001901-04
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Kim-Lien T Nguyen
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10426232

## Citation

> US National Institutes of Health, RePORTER application 10426232, Tailoring Stress Cardiac MRI for Women with Ischemic Heart Disease (5I01CX001901-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10426232. Licensed CC0.

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