Adenosine stress and rest T1-mapping differentiates ischemic, infarcted, remote and normal myocardium - a novel gadolinium-free method for ischemia detection with immediate applications in coronary artery disease

Background In stable coronary artery disease (CAD), accurate ischemia detection enables targeted revascularization, which improves clinical outcomes. Myocardial blood volume (MBV) may be a better ischemia marker than myocardial blood flow. Adenosine stress and rest T1-mapping is a novel gadolinium-free CMR technique that reflects changes in MBV through its water content. We hypothesized that different myocardial tissues in CAD patients and controls have distinctive T1-responses to adenosine, enabling ischemia detection without gadolinium agents.