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This prospective pilot study evaluated whether quantitative Ex-CMR imaging characterizes exercise-induced perfusion responses and compared MBF and MPR among hypertrophic cardiomyopathy, heart failure with preserved ejection fraction, and non-cardiac dyspnea patients.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/quantitative-myocardial-blood-flow-and-cardiovascular-magnetic-resonance-perfusion-reserve-with-exercise-research/434857/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/quantitative-myocardial-blood-flow-and-cardiovascular-magnetic-resonance-perfusion-reserve-with-exercise-research/434857.png","ImageObject",300,407,{"name":92,"@type":93},"Adam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",16,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What was the main goal of the study?","Question",{"text":113,"@type":114},"To assess the feasibility of quantitative Ex-CMR perfusion imaging for characterizing exercise-induced perfusion responses and to compare MBF and MPR across HCM, HFpEF, and non-cardiac dyspnea cohorts.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was exercise stress CMR performed in the study?",{"text":118,"@type":114},"Patients underwent Ex-CMR at 3T using a supine ergometer; exercise occurred outside the scanner bore, followed by stress perfusion imaging 45–60 seconds postexercise and rest perfusion 5–7 minutes later.",{"name":120,"@type":111,"acceptedAnswer":121},"Which patients showed differences in MBF and MPR?",{"text":122,"@type":114},"Patients with hypertrophic cardiomyopathy had significantly lower MBF and MPR than those with HFpEF and non-cardiac dyspnea.",{"name":124,"@type":111,"acceptedAnswer":125},"What predicts MBF and MPR in this dataset?",{"text":126,"@type":114},"Peak exercise heart rate was the strongest independent predictor of both MBF and MPR in the final analysis.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},434857,1790812642,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":144,"language":145,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":146,"faqs":147,"seo_title":148,"seo_description":67,"update_tm":149,"read_time":41,"preview_page_count":4},1374404737137,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Journal of Cardiovascular Magnetic Resonance 27 (2025) 101988  \nContents lists available at ScienceDirect  \nJournal of Cardiovascular Magnetic Resonance  \njournal [homepage:](homepage: www.sciencedirect.com/journal/joc mr)[ www.sciencedirect.com/journal/joc mr](homepage: www.sciencedirect.com/journal/joc mr)  \nOriginal Research  \nQuantitative myocardial blood flow and cardiovascular magnetic resonance  \nperfusion reserve with exercise  \nAlexander Schulza, Tess E. Wallacea,b, Kelvin Chowc, Xiaoming Bid, Amine Amyara, Jennifer Rodrigueza, Fahime Ghanbaria, Martin S. Marone, Ethan J. Rowine, Peter Kellmannf, Warren J. Manninga,g, Reza Nezafata,⁎  \na Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA b Siemens Medical Solutions USA, Inc, Boston, Massachusetts, USA  \nc Siemens Healthcare Ltd, Calgary, Alberta, Canada  \nd Siemens Medical Solutions USA, Inc, Los Angeles, California, USA  \ne Hypertrophic Cardiomyopathy Center, Lahey Hospital and Medical Center, Burlington, Massachusetts, USAf National Heart, Lung, and Blood Institute, National Institutes of Health, DHHS, Bethesda, Maryland, USA  \ng Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA  \nA R T I C L E I N F O  \nKeywords:  \nQuantitative myocardial perfusion Myocardial blood flow  \nExercise CMR  \nHypertrophic cardiomyopathy  \nHeart failure with preserved ejection fraction  \nA B S T R A C T  \nBackground: Myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) can be quantified using vasodilator stress cardiovascular magnetic resonance (CMR). Exercise stress CMR (Ex-CMR) offers a more physiological assessment of cardiac functional reserve. While visual interpretation of Ex-CMR perfusion has been successfully applied, the feasibility of quantitative Ex-CMR perfusion remains unproven.  \nWe aimed to assess the feasibility of quantitative Ex-CMR perfusion imaging for characterizing exerciseinduced perfusion responses and to perform a pilot study comparing MBF and MPR among patients with hypertrophic cardiomyopathy (HCM), heart failure with preserved ejection fraction (HFpEF), and non-cardiac dyspnea (NCD).  \nMethods: In this prospective study, patients with HCM, HFpEF, or NCD underwent Ex-CMR at 3T using a supine ergometer. Exercise was performed outside the scanner bore, followed by stress perfusion imaging 45-60 s postexercise and rest perfusion 5-7 min later. A dual-sequence protocol with inline pixel-wise quantification was used to calculate MBF and MPR. Image quality and feasibility were visually assessed. Group comparisons were performed using analysis of variance and t-tests; linear regression was used to explore clinical associations. Results: Of 108 patients enrolled, 9 were excluded due to obstructive coronary artery disease or reduced ejection fraction. Quantitative Ex-CMR was successful (at least one analyzable paired rest and post-exercise slice) in 90%(10/99) of cases. Most frequent quality issues were inadequate gating or arrhythmias and slice misalignment. The final cohort included 89 patients: 34 HCM, 34 HFpEF, and 21 NCD. Patients with HCM showed significantly lower MBF and MPR than HFpEF and NCD (MBF: 1.03 ± 0.27 vs 1.25 ± 0.40 and 1.13 ± 0.25 mL/min/g; MPR: 1.27 ± 0.21 vs 1.41 ± 0.29 and 1.44 ± 0.22; all p \u003C 0.05). Peak exercise heart rate was the strongest independent predictor of MBF (β = 0.009, p \u003C 0.001) and MPR (β = 0.004, p = 0.022).  \nConclusion: Ex-CMR quantitative MBF and MPR assessment is feasible in most patients after image quality control. While the increase in MBF was limited during low-to-moderate exercise intensity in this pilot study, ExCMR revealed distinct perfusion response patterns among studied cohorts.  \nAbbreviations: AHA, American Heart Association; AIF, arterial input function; CAD, coronary artery disease; CMR, cardiovascular magnetic resonance; ECG, electrocardiogram;","cbCaigkV0GqOwA1p","https://ap.wps.com/l/cbCaigkV0GqOwA1p","pdf",6181110,12,"English","# Background\n## Methods\n## Results\n## Conclusion","[{\"question\":\"What was the main goal of the study?\",\"answer\":\"To assess the feasibility of quantitative Ex-CMR perfusion imaging for characterizing exercise-induced perfusion responses and to compare MBF and MPR across HCM, HFpEF, and non-cardiac dyspnea cohorts.\"},{\"question\":\"How was exercise stress CMR performed in the study?\",\"answer\":\"Patients underwent Ex-CMR at 3T using a supine ergometer; exercise occurred outside the scanner bore, followed by stress perfusion imaging 45–60 seconds postexercise and rest perfusion 5–7 minutes later.\"},{\"question\":\"Which patients showed differences in MBF and MPR?\",\"answer\":\"Patients with hypertrophic cardiomyopathy had significantly lower MBF and MPR than those with HFpEF and non-cardiac dyspnea.\"},{\"question\":\"What predicts MBF and MPR in this dataset?\",\"answer\":\"Peak exercise heart rate was the strongest independent predictor of both MBF and MPR in the final analysis.\"}]","Quantitative myocardial blood flow and cardiovascular magnetic resonance perfusion reserve with exercise - Research | PDF",1790670852]