Assessment of myocardial oxygenation response under psychosocial stress using OS-CMR: sex-specific insights from the BMORE range

Abstract Introduction Sex-based differences in cardiovascular disease may stem from differential physiological responses to psychosocial stress. While baseline myocardial oxygenation has been studied, dynamic adaptation to stress remains poorly understood. We investigated sex-specific differences in coronary vascular function as assessed by the Breathing-enhanced Myocardial Oxygenation Response (B-MORE) using Oxygenation-Sensitive Cardiovascular Magnetic Resonance (OS-CMR), specifically using a novel biomarker—B-MORE range—derived from the Oxygenation Cardiogram (OCG). Methods In this prospective single-centre study, we included individuals with cardiovascular risk factors (obesity [BMI > 30 kg/m²], hypertension [SBP ≥ 140 mmHg or DBP ≥ 90 mmHg], or smoking) and healthy volunteers. All participants underwent OS-CMR on a 3T GE Premier scanner. Psychosocial stress was assessed using the Perceived Stress Scale (PSS), stratifying subjects into low (PSS