“Myocardial transit-time” (MyoTT): a novel and easy-to-perform CMR parameter to assess microvascular disease
Background Myocardial microvascular disease may occur during the disease course of different cardiac as well as systemic disorders. With the present study, we introduce a novel and easy-to-perform cardiovascular magnetic resonance (CMR) parameter named “myocardial transit-time” (MyoTT). Methods N =...
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| Veröffentlicht in: | Clinical research in cardiology 2020-04, Vol.109 (4), p.488-497 |
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| creator | Chatzantonis, Grigorios Bietenbeck, Michael Florian, Anca Meier, Claudia Korthals, Dennis Reinecke, Holger Yilmaz, Ali |
| description | Background
Myocardial microvascular disease may occur during the disease course of different cardiac as well as systemic disorders. With the present study, we introduce a novel and easy-to-perform cardiovascular magnetic resonance (CMR) parameter named “myocardial transit-time” (MyoTT).
Methods
N
= 20 patients with known hypertrophic cardiomyopathy (HCM) and
N
= 20 control patients without relevant cardiac disease underwent dedicated CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as first-pass perfusion acquisitions at rest for MyoTT measurement. MyoTT was defined as the blood circulation time from the orifice of the coronary arteries to the pooling in the coronary sinus (CS), and accordingly measured as the temporal difference between the appearances of CMR contrast agent in the aortic root and the CS reflecting the transit-time of gadolinium in the myocardial microvasculature.
Results
Patients with HCM had a significantly prolonged MyoTT compared to controls (11.0 (9.1–14.5) s vs. 6.5 (4.8–8.4) s,
p
|
| doi_str_mv | 10.1007/s00392-019-01530-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2261279527</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2260248562</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-d4d3c7e570fe8c6a4cea1bd77231a5496caf62cbc6767d400114e7b2027ab2f53</originalsourceid><addsrcrecordid>eNp9kc9qFTEUh4MotlZfwIUE3NRFNP8mueOuXLQWWgpyXQ9nMmdkysxkzJkpvbs-iL5cn6Spt63QhYuQwPl-vyR8jL1V8qOS0n8iKU2phVRlXoWR4uoZ21crp4R0pX7-eF7ZPfaK6ELKQkljX7I9o4xWtlT7bLq5_n22jQFS00HP5wQjdbOYuwFvrv_wwzzbbD585sDHeIk9h7HhCLQVcxQTpjamga_PvvMJEgw4Y-Jz5ECERHzoQoqXQGHpIfGmoxzE1-xFCz3hm_v9gP34-mWz_iZOz49P1kenIhhfzKKxjQkeCy9bXAUHNiCouvFeGwWFLV2A1ulQB-edb6yUSln0tZbaQ63bwhyww13vlOKvBWmuho4C9j2MGBeqtHZK-7LQPqPvn6AXcUljft0dJbVdFU5nSu-o_CmihG01pW6AtK2UrO58VDsfVfZR_fVRXeXQu_vqpR6weYw8CMiA2QGUR-NPTP_u_k_tLQfCmBg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2260248562</pqid></control><display><type>article</type><title>“Myocardial transit-time” (MyoTT): a novel and easy-to-perform CMR parameter to assess microvascular disease</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Chatzantonis, Grigorios ; Bietenbeck, Michael ; Florian, Anca ; Meier, Claudia ; Korthals, Dennis ; Reinecke, Holger ; Yilmaz, Ali</creator><creatorcontrib>Chatzantonis, Grigorios ; Bietenbeck, Michael ; Florian, Anca ; Meier, Claudia ; Korthals, Dennis ; Reinecke, Holger ; Yilmaz, Ali</creatorcontrib><description>Background
Myocardial microvascular disease may occur during the disease course of different cardiac as well as systemic disorders. With the present study, we introduce a novel and easy-to-perform cardiovascular magnetic resonance (CMR) parameter named “myocardial transit-time” (MyoTT).
Methods
N
= 20 patients with known hypertrophic cardiomyopathy (HCM) and
N
= 20 control patients without relevant cardiac disease underwent dedicated CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as first-pass perfusion acquisitions at rest for MyoTT measurement. MyoTT was defined as the blood circulation time from the orifice of the coronary arteries to the pooling in the coronary sinus (CS), and accordingly measured as the temporal difference between the appearances of CMR contrast agent in the aortic root and the CS reflecting the transit-time of gadolinium in the myocardial microvasculature.
Results
Patients with HCM had a significantly prolonged MyoTT compared to controls (11.0 (9.1–14.5) s vs. 6.5 (4.8–8.4) s,
p
< 0.001). This significant difference did not change when the individual heart rate was taken into consideration (MyoTT indexed,
p
< 0.001). Significant correlations were found between MyoTT and maximal left ventricular (LV) wall thickness (
r
= 0.771,
p
< 0.001), MyoTT and presence of LGE (
r
= 0.760,
p
< 0.001) as well as MyoTT and LV global longitudinal strain (
r
= 0.672,
p
< 0.001). ROC analysis resulted in an area-under-curve (AUC) of 0.90 for MyoTT and showed an optimal sensitivity/specificity cut-off of 7.85 s to differentiate HCM from controls.
Conclusion
“Myocardial transit-time” is a novel and easy-to-perform CMR parameter that allows a quick assessment of the extent of myocardial microvascular disease. This novel CMR parameter may open new vistas in the assessment of microvascular disease—not only in HCM patients. Future studies will show the usefulness and clinical relevance of this novel CMR parameter.
Graphic abstract</description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-019-01530-x</identifier><identifier>PMID: 31321491</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aorta ; Arteries ; Blood circulation ; Blood Flow Velocity ; Cardiology ; Cardiomyopathy ; Cardiomyopathy, Hypertrophic - diagnostic imaging ; Cardiomyopathy, Hypertrophic - physiopathology ; Case-Control Studies ; Contrast agents ; Contrast Media - administration & dosage ; Coronary artery disease ; Coronary Circulation ; Disease control ; Female ; Gadolinium ; Heart diseases ; Heart rate ; Humans ; Magnetic resonance ; Magnetic Resonance Imaging, Cine ; Male ; Medicine ; Medicine & Public Health ; Microcirculation ; Microvasculature ; Middle Aged ; Myocardial Perfusion Imaging ; Organometallic Compounds - administration & dosage ; Orifices ; Original Paper ; Parameters ; Perfusion ; Predictive Value of Tests ; Time Factors ; Transit ; Ventricle ; Wall thickness</subject><ispartof>Clinical research in cardiology, 2020-04, Vol.109 (4), p.488-497</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Clinical Research in Cardiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-d4d3c7e570fe8c6a4cea1bd77231a5496caf62cbc6767d400114e7b2027ab2f53</citedby><cites>FETCH-LOGICAL-c375t-d4d3c7e570fe8c6a4cea1bd77231a5496caf62cbc6767d400114e7b2027ab2f53</cites><orcidid>0000-0003-4526-8679</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00392-019-01530-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00392-019-01530-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31321491$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chatzantonis, Grigorios</creatorcontrib><creatorcontrib>Bietenbeck, Michael</creatorcontrib><creatorcontrib>Florian, Anca</creatorcontrib><creatorcontrib>Meier, Claudia</creatorcontrib><creatorcontrib>Korthals, Dennis</creatorcontrib><creatorcontrib>Reinecke, Holger</creatorcontrib><creatorcontrib>Yilmaz, Ali</creatorcontrib><title>“Myocardial transit-time” (MyoTT): a novel and easy-to-perform CMR parameter to assess microvascular disease</title><title>Clinical research in cardiology</title><addtitle>Clin Res Cardiol</addtitle><addtitle>Clin Res Cardiol</addtitle><description>Background
Myocardial microvascular disease may occur during the disease course of different cardiac as well as systemic disorders. With the present study, we introduce a novel and easy-to-perform cardiovascular magnetic resonance (CMR) parameter named “myocardial transit-time” (MyoTT).
Methods
N
= 20 patients with known hypertrophic cardiomyopathy (HCM) and
N
= 20 control patients without relevant cardiac disease underwent dedicated CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as first-pass perfusion acquisitions at rest for MyoTT measurement. MyoTT was defined as the blood circulation time from the orifice of the coronary arteries to the pooling in the coronary sinus (CS), and accordingly measured as the temporal difference between the appearances of CMR contrast agent in the aortic root and the CS reflecting the transit-time of gadolinium in the myocardial microvasculature.
Results
Patients with HCM had a significantly prolonged MyoTT compared to controls (11.0 (9.1–14.5) s vs. 6.5 (4.8–8.4) s,
p
< 0.001). This significant difference did not change when the individual heart rate was taken into consideration (MyoTT indexed,
p
< 0.001). Significant correlations were found between MyoTT and maximal left ventricular (LV) wall thickness (
r
= 0.771,
p
< 0.001), MyoTT and presence of LGE (
r
= 0.760,
p
< 0.001) as well as MyoTT and LV global longitudinal strain (
r
= 0.672,
p
< 0.001). ROC analysis resulted in an area-under-curve (AUC) of 0.90 for MyoTT and showed an optimal sensitivity/specificity cut-off of 7.85 s to differentiate HCM from controls.
Conclusion
“Myocardial transit-time” is a novel and easy-to-perform CMR parameter that allows a quick assessment of the extent of myocardial microvascular disease. This novel CMR parameter may open new vistas in the assessment of microvascular disease—not only in HCM patients. Future studies will show the usefulness and clinical relevance of this novel CMR parameter.
Graphic abstract</description><subject>Adult</subject><subject>Aged</subject><subject>Aorta</subject><subject>Arteries</subject><subject>Blood circulation</subject><subject>Blood Flow Velocity</subject><subject>Cardiology</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Hypertrophic - diagnostic imaging</subject><subject>Cardiomyopathy, Hypertrophic - physiopathology</subject><subject>Case-Control Studies</subject><subject>Contrast agents</subject><subject>Contrast Media - administration & dosage</subject><subject>Coronary artery disease</subject><subject>Coronary Circulation</subject><subject>Disease control</subject><subject>Female</subject><subject>Gadolinium</subject><subject>Heart diseases</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Magnetic resonance</subject><subject>Magnetic Resonance Imaging, Cine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microcirculation</subject><subject>Microvasculature</subject><subject>Middle Aged</subject><subject>Myocardial Perfusion Imaging</subject><subject>Organometallic Compounds - administration & dosage</subject><subject>Orifices</subject><subject>Original Paper</subject><subject>Parameters</subject><subject>Perfusion</subject><subject>Predictive Value of Tests</subject><subject>Time Factors</subject><subject>Transit</subject><subject>Ventricle</subject><subject>Wall thickness</subject><issn>1861-0684</issn><issn>1861-0692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc9qFTEUh4MotlZfwIUE3NRFNP8mueOuXLQWWgpyXQ9nMmdkysxkzJkpvbs-iL5cn6Spt63QhYuQwPl-vyR8jL1V8qOS0n8iKU2phVRlXoWR4uoZ21crp4R0pX7-eF7ZPfaK6ELKQkljX7I9o4xWtlT7bLq5_n22jQFS00HP5wQjdbOYuwFvrv_wwzzbbD585sDHeIk9h7HhCLQVcxQTpjamga_PvvMJEgw4Y-Jz5ECERHzoQoqXQGHpIfGmoxzE1-xFCz3hm_v9gP34-mWz_iZOz49P1kenIhhfzKKxjQkeCy9bXAUHNiCouvFeGwWFLV2A1ulQB-edb6yUSln0tZbaQ63bwhyww13vlOKvBWmuho4C9j2MGBeqtHZK-7LQPqPvn6AXcUljft0dJbVdFU5nSu-o_CmihG01pW6AtK2UrO58VDsfVfZR_fVRXeXQu_vqpR6weYw8CMiA2QGUR-NPTP_u_k_tLQfCmBg</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Chatzantonis, Grigorios</creator><creator>Bietenbeck, Michael</creator><creator>Florian, Anca</creator><creator>Meier, Claudia</creator><creator>Korthals, Dennis</creator><creator>Reinecke, Holger</creator><creator>Yilmaz, Ali</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4526-8679</orcidid></search><sort><creationdate>20200401</creationdate><title>“Myocardial transit-time” (MyoTT): a novel and easy-to-perform CMR parameter to assess microvascular disease</title><author>Chatzantonis, Grigorios ; Bietenbeck, Michael ; Florian, Anca ; Meier, Claudia ; Korthals, Dennis ; Reinecke, Holger ; Yilmaz, Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-d4d3c7e570fe8c6a4cea1bd77231a5496caf62cbc6767d400114e7b2027ab2f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aorta</topic><topic>Arteries</topic><topic>Blood circulation</topic><topic>Blood Flow Velocity</topic><topic>Cardiology</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Hypertrophic - diagnostic imaging</topic><topic>Cardiomyopathy, Hypertrophic - physiopathology</topic><topic>Case-Control Studies</topic><topic>Contrast agents</topic><topic>Contrast Media - administration & dosage</topic><topic>Coronary artery disease</topic><topic>Coronary Circulation</topic><topic>Disease control</topic><topic>Female</topic><topic>Gadolinium</topic><topic>Heart diseases</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Magnetic resonance</topic><topic>Magnetic Resonance Imaging, Cine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microcirculation</topic><topic>Microvasculature</topic><topic>Middle Aged</topic><topic>Myocardial Perfusion Imaging</topic><topic>Organometallic Compounds - administration & dosage</topic><topic>Orifices</topic><topic>Original Paper</topic><topic>Parameters</topic><topic>Perfusion</topic><topic>Predictive Value of Tests</topic><topic>Time Factors</topic><topic>Transit</topic><topic>Ventricle</topic><topic>Wall thickness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chatzantonis, Grigorios</creatorcontrib><creatorcontrib>Bietenbeck, Michael</creatorcontrib><creatorcontrib>Florian, Anca</creatorcontrib><creatorcontrib>Meier, Claudia</creatorcontrib><creatorcontrib>Korthals, Dennis</creatorcontrib><creatorcontrib>Reinecke, Holger</creatorcontrib><creatorcontrib>Yilmaz, Ali</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chatzantonis, Grigorios</au><au>Bietenbeck, Michael</au><au>Florian, Anca</au><au>Meier, Claudia</au><au>Korthals, Dennis</au><au>Reinecke, Holger</au><au>Yilmaz, Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>“Myocardial transit-time” (MyoTT): a novel and easy-to-perform CMR parameter to assess microvascular disease</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>109</volume><issue>4</issue><spage>488</spage><epage>497</epage><pages>488-497</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><abstract>Background
Myocardial microvascular disease may occur during the disease course of different cardiac as well as systemic disorders. With the present study, we introduce a novel and easy-to-perform cardiovascular magnetic resonance (CMR) parameter named “myocardial transit-time” (MyoTT).
Methods
N
= 20 patients with known hypertrophic cardiomyopathy (HCM) and
N
= 20 control patients without relevant cardiac disease underwent dedicated CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as first-pass perfusion acquisitions at rest for MyoTT measurement. MyoTT was defined as the blood circulation time from the orifice of the coronary arteries to the pooling in the coronary sinus (CS), and accordingly measured as the temporal difference between the appearances of CMR contrast agent in the aortic root and the CS reflecting the transit-time of gadolinium in the myocardial microvasculature.
Results
Patients with HCM had a significantly prolonged MyoTT compared to controls (11.0 (9.1–14.5) s vs. 6.5 (4.8–8.4) s,
p
< 0.001). This significant difference did not change when the individual heart rate was taken into consideration (MyoTT indexed,
p
< 0.001). Significant correlations were found between MyoTT and maximal left ventricular (LV) wall thickness (
r
= 0.771,
p
< 0.001), MyoTT and presence of LGE (
r
= 0.760,
p
< 0.001) as well as MyoTT and LV global longitudinal strain (
r
= 0.672,
p
< 0.001). ROC analysis resulted in an area-under-curve (AUC) of 0.90 for MyoTT and showed an optimal sensitivity/specificity cut-off of 7.85 s to differentiate HCM from controls.
Conclusion
“Myocardial transit-time” is a novel and easy-to-perform CMR parameter that allows a quick assessment of the extent of myocardial microvascular disease. This novel CMR parameter may open new vistas in the assessment of microvascular disease—not only in HCM patients. Future studies will show the usefulness and clinical relevance of this novel CMR parameter.
Graphic abstract</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31321491</pmid><doi>10.1007/s00392-019-01530-x</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-4526-8679</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1861-0684 |
| ispartof | Clinical research in cardiology, 2020-04, Vol.109 (4), p.488-497 |
| issn | 1861-0684 1861-0692 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aorta Arteries Blood circulation Blood Flow Velocity Cardiology Cardiomyopathy Cardiomyopathy, Hypertrophic - diagnostic imaging Cardiomyopathy, Hypertrophic - physiopathology Case-Control Studies Contrast agents Contrast Media - administration & dosage Coronary artery disease Coronary Circulation Disease control Female Gadolinium Heart diseases Heart rate Humans Magnetic resonance Magnetic Resonance Imaging, Cine Male Medicine Medicine & Public Health Microcirculation Microvasculature Middle Aged Myocardial Perfusion Imaging Organometallic Compounds - administration & dosage Orifices Original Paper Parameters Perfusion Predictive Value of Tests Time Factors Transit Ventricle Wall thickness |
| title | “Myocardial transit-time” (MyoTT): a novel and easy-to-perform CMR parameter to assess microvascular disease |
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