Cardiac Microvascular Disease Quantified with CMR

Sammanfattning: This thesis has investigated three different diagnoses where cardiac microvascular disease is suspected: hypertrophic cardiomyopathy (HCM), systemic sclerosis (SSc), and patients with suspected microvascular angina (MVA).Study I of this thesis investigated patients with HCM. We investigated the myocardial perfusion (MP) using cardiac magnetic resonance imaging (CMR) in young patients with HCM or the risk of developing the disease. The investigation found that the patients had lower blood flow of the heart muscle than a reference group with healthy volunteers. This finding was interpreted as a sign of cardiac microvascular disease.Study II investigated patients with SSc, which is a complex rheumatic disease with multiorgan involvement. The investigation showed that the patients had lower blood flow through the heart muscle than a reference group with healthy volunteers. This finding was interpreted as a sign of cardiac microvascular disease.Study III Investigated patients with suspected MVA. The investigation showed that these patients had lower global MP than a reference group of healthy volunteers, but not as low as another reference group with patients with known coronary artery disease. The finding was interpreted as a sign of cardiac microvascular disease in this group of patients.Study IV aimed to collect reference values for coronary sinus (CS) flow derived global MP and to validate the method against a flow phantom. The study showed that global MP was lower in men than women, which needs to be recognized when interpreting a quantitative assessment of global MP. The study also showed that the CS flow method is accurate compared to a flow phantom