Heart rate adaptive maximal resolution cardiovascular magnetic resonance myocardial stress perfusion imaging at 3.0T

Background Myocardial perfusion cardiovascular magnetic resonance (CMR) with vasodilator stress has high diagnostic accuracy for detecting coronary artery disease (CAD). Current CMR perfusion pulse sequences use largely fixed acquisition parameters designed to acquire at least three slices every heart beat, optimized for the heart rates that typically occur during pharmacological stress. In patients with lower heart rates there can be a significant amount of unused potential imaging time [Figure 1]. In those with higher heart rates, acquisition with fixed parameters may not be possible at every heart beat. A more flexible acquisition scheme could optimize acquisition parameters specifically for each patient and heart rate with potential improvements in image quality or temporal resolution. We aimed to assess the feasibility of a perfusion pulse sequence which adapts to the heart rate, maximizing imaging time and acquired spatial resolution.