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Functional Assessment of the Coronary Physiology: The Role of Magnetic Resonance

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Coronary Circulation and Myocardial Ischemia

Part of the book series: Update in Intensive Care Medicine ((UICMSOFT,volume 32))

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Abstract

Nuclear Magnetic Resonance has recently emerged in cardiac physiology and cardiology. The absence of radiation exposure, the capability of imaging the entire heart volume, the development of fast imaging methods that can be performed on conventional MR systems are some of the several advantages, that have made MRI a reference imaging technique for evaluation of cardiac and coronary physiology. The MR signal depends on multiple parameters that all together represent the various aspects of cardiac metabolisms and functions: chemical composition, molecular motion, diffusion, physical state, water and lipid content, fiber orientation, perfusion, flow velocity. Fast MR imaging sequences use this dependence in order to assess: coronary anatomy (MR coronarography) and flow reserve (velocity by phase gradient encoding or time-of-flight), coronary wall imaging (spiral gradients), microcirculation (perfusion with endogenous or exogenous contrast agents), fiber orientation (diffusion) and contractility (tagging), high-energy phosphate metabolism, oxygen consumption and viability (by 31-Phosphorus or myoglobin spectroscopy), or global ventricular function. Spatial and temporal resolutions have considerably increased: images can now be acquired in less than 50 ms with a submillimetric matrix (Fig. 1). Also, the aforementioned parameters can be evaluated at rest and under physiological or pharmacological stress, and combined in a single comprehensive examination. This evaluation has the potential of aiding physicians in their therapeutic decisions eg coronary revascularization and helping them to plan and follow measures of primary or secondary prevention. Respecting the usual contraindications [1], MRI is safe and applicable even in the acute phase of a myocardial infarction. Echoplanar, Turboflash and Spiral interactive realtime imaging are the major methods which make this technology a major instrument of clinical and basic research in coronary physiology. Anatomy: MR Angiography and Tissue Characterization

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Authors and Affiliations

  1. Service de Physiologie et Radioisotopes, Hôpital Broussais, Paris, France

    J. F. Toussaint

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  1. J. F. Toussaint
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Editors and Affiliations

  1. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Michael R. Pinsky MD, CM, FCCP, FCCM (Director of Research Division of Critical Care Medicine Professor of Anesthesiology and Critical Care Medicine) (Director of Research Division of Critical Care Medicine Professor of Anesthesiology and Critical Care Medicine)

  2. Department of Cell Biology and Physiology, Autonomous University, Barcelona, Spain

    Antonio Artigas MD, PhD (Director of Critical Care Center Sabadell Hospital Associate Professor) (Director of Critical Care Center Sabadell Hospital Associate Professor)

  3. Paris, France

    Jean-Francois Dhainaut MD, PhD (Director of Medical Intensive Care Unit Dean of Cochin Port-Royal Medical School Vice-President of Paris University) (Director of Medical Intensive Care Unit Dean of Cochin Port-Royal Medical School Vice-President of Paris University)

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© 2002 Springer-Verlag Berlin Heidelberg

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Toussaint, J.F. (2002). Functional Assessment of the Coronary Physiology: The Role of Magnetic Resonance. In: Pinsky, M.R., Artigas, A., Dhainaut, JF. (eds) Coronary Circulation and Myocardial Ischemia. Update in Intensive Care Medicine, vol 32. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57212-8_10

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  • DOI: https://doi.org/10.1007/978-3-642-57212-8_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-42588-5

  • Online ISBN: 978-3-642-57212-8

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