Real-time cine first-pass perfusion imaging enables rapid detection of functionally significant high-grade coronary stenosis

Background Among the spectrum of patients with coronary artery disease (CAD), those suffering from high-grade stenosis are at a significantly elevated risk for adverse events [1]. Such high-grade disease may result in the so-called “coronary steal” phenomenon under vasodilator stress [2] thereby inducing wall-motion abnormalities (WMAs) in the affected territories, referred to as transient ischemic dilation. We developed a “real time” cine first-pass perfusion (FPP) CMR method for concurrent imaging of myocardial function and perfusion. We hypothesized that this method is capable of simultaneously capturing stress-induced perfusion defects and WMAs in a single ungated scan.