# Validation of Myocardial Oxygen Extraction Fraction Measurement with MRI

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2024 · $641,786

## Abstract

Imbalance of myocardial oxygen supply and consumption precipitates a cascade of physiological changes
resulting in ischemic pathology. While assessment of myocardial perfusion alone may allow accurate
assessment of myocardial oxygen consumption in some pathophysiological conditions, the perfusion-oxygen
consumption relationship is derailed in several conditions, including: myocardial ischemia and infarction,
hypertrophic and dilated cardiomyopathies, heart failure, valvular heart disease, and septic cardiomyopathy.
Importantly, this oxygen supply/perfusion mismatch occurs early – before mechanical dysfunction. Therefore,
evaluation of myocardial consumption independent of perfusion is of importance for early diagnosis and
monitoring of these pathophysiological conditions. Myocardial oxygen extraction fraction (mOEF), which relates
the biologic coupling of myocardial blood flow (oxygen supply) to oxygen consumption, may provide a more
accurate assessment of this balance. For example, in ischemic cardiomyopathy, adequate myocardial perfusion
is commonly reduced by high grade epicardial coronary artery stenoses. To avoid ischemia-caused injury, mOEF
is likely to be increased to compensate for decrease in myocardial perfusion and oxygen delivery to myocytes.
Consequently, the affected myocardial regions drop into a so called “hibernating” state that is effective in the
short term. In this respect, an accurate mOEF assessment is a unique tool, with the potential to determine the
likelihood of cardiac functional recovery after reperfusion. To date, the reference method for non-invasive
quantification of mOEF in vivo is Positron Emission Tomography (PET). We recently developed a novel contrast-
free cardiovascular magnetic resonance (CMR) acquisition method to quantify mOEF in vivo that has several
advantages over PET: our CMR method has better spatial resolution, shorter acquisition time, does not expose
the patient to ionizing radiation, and could be more widely available than PET. The overall objective of this
study is to leverage our expertise in CMR imaging to refine and rigorously validate this new mOEF method. In
Aim 1. This technique will be developed with assistance of a novel deep learning approach for artifact-free
images and then validated using large animal models with and without induced coronary artery disease. Invasive
catheter-measured and non-invasive PET-MRI-measured mOEF will be used as reference. In Aim 2, the CMR
mOEF method will be validated in a small cohort of patients with hibernating myocardium in vivo, with the
availability of 18F-FDG-PET as reference. Although we will study this mOEF technique in hibernating myocardium,
this imaging method can be applied to the diagnosis and evaluation of treatments in a wide range of
cardiomyopathies. Given the capability of CMR for the comprehensive assessment of myocardial function, tissue
characterization, and viability, successful completion of CMR mOEF validation will provide a ‘one-st...

## Key facts

- **NIH application ID:** 10906985
- **Project number:** 5R01HL165238-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Pamela K Woodard
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $641,786
- **Award type:** 5
- **Project period:** 2023-08-15 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10906985

## Citation

> US National Institutes of Health, RePORTER application 10906985, Validation of Myocardial Oxygen Extraction Fraction Measurement with MRI (5R01HL165238-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10906985. Licensed CC0.

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