Limited flow reserve in non-obstructed bypass grafts supplying infarcted myocardium: implications for cardiovascular magnetic resonance imaging protocols

J Cardiovasc Magn Reson. 2006;8(2):373-9. doi: 10.1080/10976640500452067.

Abstract

We evaluated flow reserve in non-obstructed bypass grafts supplying infarcted and noninfarcted myocardium. Bypass grafts were examined by phase-contrast flow measurements and myocardial viability was assessed with late enhancement technique. Flow reserve was higher in bypasses supplying normal myocardium compared to those supplying infarcted myocardium (2.9 vs. 1.5, p<.0001). This difference remained significant after adjusting for co-variables. Bypass grafts supplying infarcted myocardium were more likely to have lower flow reserve than those supplying normal myocardium (flow reserve < or =2, 84% vs 18%, p = .0003). Flow reserve is reduced in non-stenosed bypasses supplying infarcted myocardium, likely due to altered microcirculation. Thus, cardiovascular magnetic resonance based bypass assessment must include myocardial viability testing.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical
  • Blood Flow Velocity / physiology*
  • Coronary Angiography
  • Coronary Artery Bypass*
  • Coronary Circulation / physiology*
  • Electrocardiography
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Myocardial Infarction / physiopathology*
  • Myocardial Infarction / surgery
  • Retrospective Studies