Validation of perfusion dyssynchrony indices as a novel non-invasive diagnostic tool in the detection of hemodynamically significant coronary artery disease in the setting of three dimensional (3D) myocardial perfusion CMR

Background Perfusion dyssynchrony analysis provides a novel insight into the evaluation of myocardial ischaemia due to coronary artery disease (CAD). Perfusion dyssynchrony indices measure differences in the temporal distribution of the wash-in of contrast agents across the left ventricular wall. In a previous 2D study the temporal dyssynchrony of LV perfusion was measured using four indices variance and coefficient of variation of the time to maximum signal upslope (V-TTMU and C-TTMU), and variance, and coefficient of variation of the time to peak myocardial signal enhancement (V-TTP and C-TTP).{Chiribiri:2014en} TTP detected CAD better than TTMU, with C-TTP being the most sensitive. 3D myocardial perfusion CMR provides the advantage of whole heart coverage at the expense of inferior in plane spatial resolution. Our aim was to validate perfusion dyssynchrony analysis on 3D perfusion datasets to detect significant CAD.