# High-Resolution Whole Heart Quantitative CMR Perfusion Imaging in Ischemic Heart Disease

> **NIH NIH R01** · UNIVERSITY OF VIRGINIA · 2020 · $740,787

## Abstract

7. Project Summary
 As greater than 8 million Americans suffer from angina due to obstructive coronary artery disease (CAD) or
microvascular disease (MVD), which are both associated with an increased risk for adverse cardiovascular
events, accurate non-invasive assessment of the presence and functional significance of obstructive CAD and
evaluation of MVD is of substantial clinical importance. While both CAD and MVD are characterized by
abnormal coronary flow reserve (CFR), this parameter alone is insufficient to distinguish between these two
conditions which have different management strategies. High-resolution whole-heart quantitative adenosine
stress cardiac magnetic resonance (CMR) has the potential to provide a new tool to differentiate between
these entities based on its ability to quantify differences between endocardial and epicardial perfusion.
However, 3D quantitative adenosine stress CMR still suffers from a number of important limitations including
limited spatial coverage, low in-plane spatial resolution, long temporal acquisition windows, and sensitivity to
cardiac and respiratory motion. We have been developing efficient high-resolution 2D spiral CMR perfusion
pulse sequences to overcome these limitations while providing whole-heart coverage.
 The broad long-term objective of this project is to develop robust high-resolution quantitative CMR perfusion
techniques with whole-heart coverage to understand the development of perfusion abnormalities in animal
models of microvascular disease and obstructive CAD, and to utilize these CMR techniques to improve the
non-invasive diagnosis and risk stratification of patients with CAD and MVD. Improved diagnostic techniques
for assessing myocardial perfusion in CAD and MVD could significantly reduce the need for invasive coronary
angiography among patients being evaluated for angina.
 The specific aims for this project are: (1) To develop an efficient high-resolution 2D spiral-based perfusion
technique for robust, motion-insensitive and accurate measurements of myocardial perfusion and endocardial
to epicardial (endo:ep) perfusion ratio. (2) To test the hypothesis that CMR accurately measures endo:epi
perfusion ratios and detects a lower endo:epi ratio in obstructive CAD as compared to MVD in a porcine model.
(3) To develop an algorithm using CMR derived MPR and endo:epi perfusion ratios to differentiate CAD from
MVD in patients presenting with angina and known or suspected CAD.
 Successful completion of this project will result in an efficient, robust, and well-validated technique for high-
resolution whole-heart quantification of myocardial perfusion able to accurately detect endo:epi perfusion
gradients, quantify MPR and myocardial ischemic burden, and differentiate obstructive CAD from MVD. The
very short temporal footprint and motion-insensitive reconstruction will enable robust perfusion quantification in
patients with increased heart rates and inability to perform breath-holding extendin...

## Key facts

- **NIH application ID:** 9858443
- **Project number:** 5R01HL131919-04
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** Michael Salerno
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $740,787
- **Award type:** 5
- **Project period:** 2017-02-01 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9858443

## Citation

> US National Institutes of Health, RePORTER application 9858443, High-Resolution Whole Heart Quantitative CMR Perfusion Imaging in Ischemic Heart Disease (5R01HL131919-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9858443. Licensed CC0.

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