102 Chapter 5 Figure 5. Quantitative perfusion CMR. (A) Rest MBF on SAX of the basal, mid-LV and apical slice, (B) Stress MBF on SAX of the basal, mid-LV and apical slice, (C) Polar maps demonstrating rest and stress MBF in each segment, (D) Polar maps of rMPR and MPRI in each segment. Abbrevations: CMR: Cardiac Magnetic Resonance; MBF: Myocardial Blood Flow; SAX: short-axis images; LV: Left ventricle; rMPR: relative Myocardial Perfusion Reserve; MPRI: Myocardial Perfusion Reserve Index T1-mapping is applied to assess MBV and extracellular volume (ECV). For this purpose, short-axis images at mid-ventricular level and 4-chamber long axis images are acquired using the MOdified Look-Locker Inversion (MOLLI) sequence with a 5S(3s)3s sampling scheme, during rest and adenosine injection (adenosine infusion 140 μg/kg/min) and after administration of gadolinium.47, 48 All CMR images are collected centrally and are analyzed using Circle (Circle Cardiovascular Imaging Inc., Calgary, Alberta, Canada). Peripheral Microvascular Function The EndoPAT (Peripheral Artery Tonometer, Itamar Medical, Israel) is a device used to non-invasively assess microvascular function. By using the EndoPAT insight is given in the functioning of the endothelial and smooth muscle cells of the patients as well as the healthy controls, since this latter group does not undergo CFT. The EndoPAT is non-operator-dependent, and records post-ischemic reactive hyperemia known as the PAT (Peripheral Arterial Tone) signal using plethysmographic probes. These probes are placed on the index finger of both hands. First a baseline flow-signal is obtained for 5 min. Subsequently, flow-mediated changes are evoked by occluding blood flow through the
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