scholarly journals Comparison of Positron Emission Tomography Measurement of Adenosine-Stimulated Absolute Myocardial Blood Flow Versus Relative Myocardial Tracer Content for Physiological Assessment of Coronary Artery Stenosis Severity and Location

2009 ◽  
Vol 2 (6) ◽  
pp. 751-758 ◽  
Author(s):  
Mohammad M. Hajjiri ◽  
Marcia B. Leavitt ◽  
Hui Zheng ◽  
Amy E. Spooner ◽  
Alan J. Fischman ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Coronary Artery Stenosis ◽  
Emission Tomography ◽  
Absolute Myocardial Blood Flow ◽  
Positron Emission ◽  
Physiological Assessment ◽  
Stenosis Severity

scholarly journals Improved regional myocardial blood flow and flow reserve after coronary revascularization as assessed by serial 15O-water positron emission tomography/computed tomography

2019 ◽  
Vol 21 (1) ◽  
pp. 36-46 ◽  
Author(s):  
Tadao Aikawa ◽  
Masanao Naya ◽  
Kazuhiro Koyanagawa ◽  
Osamu Manabe ◽  
Masahiko Obara ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Coronary Revascularization ◽  
Emission Tomography ◽  
Regional Stress ◽  
Flow Reserve ◽  
Positron Emission ◽  
Stable Cad

Abstract Aims Myocardial perfusion imaging without and with quantitative myocardial blood flow (MBF) and myocardial flow reserve (MFR) plays an important role in the diagnosis and risk stratification of patients with stable coronary artery disease (CAD). We aimed to quantify the effects of coronary revascularization on regional stress MBF and MFR and to determine whether the presence of subendocardial infarction was associated with these changes. Methods and results Forty-seven patients with stable CAD were prospectively enrolled. They underwent 15O-water positron emission tomography at baseline and 6 months after optimal medical therapy alone (n = 16), percutaneous coronary intervention (PCI) (n = 18), or coronary artery bypass grafting (CABG) (n = 13). Stenosis of ≥50% diameter was detected in 98/141 vessels (70%). The regional MFR was significantly increased from baseline to follow-up [1.84 (interquartile range, IQR 1.28–2.17) vs. 2.12 (IQR 1.69–2.63), P < 0.001] in vessel territories following PCI or CABG due to an increase in the stress MBF [1.33 (IQR 0.97–1.67) mL/g/min vs. 1.64 (IQR 1.38–2.17) mL/g/min, P < 0.001], whereas there was no significant change in the regional stress MBF or MFR in vessel territories without revascularization. A multilevel mixed-effects models adjusted for baseline characteristics, subendocardial infarction assessed by cardiovascular magnetic resonance imaging, and intra-patient correlation showed that the degree of angiographic improvement after coronary revascularization was significantly associated with increased regional stress MBF and MFR (P < 0.05 for all). Conclusion Coronary revascularization improved the regional stress MBF and MFR in patients with stable CAD. The magnitude of these changes was associated with the extent of revascularization independent of subendocardial infarction.

scholarly journals Incremental prognostic value of hybrid [15O]H2O positron emission tomography–computed tomography: combining myocardial blood flow, coronary stenosis severity, and high-risk plaque morphology

2020 ◽  
Vol 21 (10) ◽  
pp. 1105-1113 ◽  
Author(s):  
Roel S Driessen ◽  
Michiel J Bom ◽  
Pepijn A van Diemen ◽  
Stefan P Schumacher ◽  
Remi M Leonora ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Blood Flow ◽  
High Risk ◽  
Myocardial Blood Flow ◽  
Prognostic Value ◽  
Emission Tomography ◽  
Plaque Morphology ◽  
Positron Emission ◽  
Stenosis Severity

Abstract Aims  This study sought to determine the prognostic value of combined functional testing using positron emission tomography (PET) perfusion imaging and anatomical testing using coronary computed tomography angiography (CCTA)-derived stenosis severity and plaque morphology in patients with suspected coronary artery disease (CAD). Methods and results  In this retrospective study, 539 patients referred for hybrid [15O]H2O PET-CT imaging because of suspected CAD were investigated. PET was used to determine myocardial blood flow (MBF), whereas CCTA images were evaluated for obstructive stenoses and high-risk plaque (HRP) morphology. Patients were followed up for the occurrence of all-cause death and non-fatal myocardial infarction (MI). During a median follow-up of 6.8 (interquartile range 4.8–7.8) years, 42 (7.8%) patients experienced events, including 23 (4.3%) deaths, and 19 (3.5%) MIs. Annualized event rates for normal vs. abnormal results of PET MBF, CCTA-derived stenosis, and HRP morphology were 0.6 vs. 2.1%, 0.4 vs. 2.1%, and 0.8 vs. 2.8%, respectively (P < 0.001 for all). Cox regression analysis demonstrated prognostic values of PET perfusion imaging [hazard ratio (HR) 3.75 (1.84–7.63), P < 0.001], CCTA-derived stenosis [HR 5.61 (2.36–13.34), P < 0.001], and HRPs [HR 3.37 (1.83–6.18), P < 0.001] for the occurrence of death or MI. However, only stenosis severity [HR 3.01 (1.06–8.54), P = 0.039] and HRPs [HR 1.93 (1.00–3.71), P = 0.049] remained independently associated. Conclusion  PET-derived MBF, CCTA-derived stenosis severity, and HRP morphology were univariably associated with death and MI, whereas only stenosis severity and HRP morphology provided independent prognostic value.

scholarly journals Coronary artery lumen volume index as a marker of flow-limiting atherosclerosis—validation against 13N-ammonia positron emission tomography

2021 ◽  
Author(s):  
Georgios Benetos ◽  
Dominik C. Benz ◽  
Georgios P. Rampidis ◽  
Andreas A. Giannopoulos ◽  
Elia von Felten ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Coronary Computed Tomography Angiography ◽  
Emission Tomography ◽  
Myocardial Mass ◽  
C Statistic ◽  
Incremental Value ◽  
Positron Emission

Abstract Objectives Coronary artery volume indexed to left myocardial mass (CAVi), derived from coronary computed tomography angiography (CCTA), has been proposed as an indicator of diffuse atherosclerosis. We investigated the association of CAVi with quantitative flow parameters and its ability to predict ischemia as derived from 13N-ammonia positron emission tomography myocardial perfusion imaging (PET-MPI). Methods Sixty patients who underwent hybrid CCTA/PET-MPI due to suspected CAD were retrospectively included. CAVi was defined as total coronary artery lumen volume over myocardial mass, both derived from CCTA. From PET-MPI, quantitative stress and rest myocardial blood flow (MBF) and myocardial flow reserve (MFR) were obtained and correlated with CAVi, and semi-quantitative perfusion images were analyzed for the presence of ischemia. Harrell’s c-statistic and net reclassification improvement (NRI) analysis were performed to evaluate the incremental value of CAVi over the CCTA model (i.e., stenosis > 50% and > 70%). Results CAVi correlated moderately with stress MBF and MFR (R = 0.50, p < 0.001, and R = 0.39, p = 0.002). Mean stress MBF and MFR were lower in patients with low (i.e., ≤ 20.2 mm3/g, n = 24) versus high (i.e., > 20.2 mm3/g, n = 36) CAVi (p < 0.001 for both comparisons). CAVi was independently associated with abnormal stress MBF (OR 0.90, 95% CI 0.82–0.998, p = 0.045). CAVi increased the predictive ability of the CCTA model for abnormal stress MBF and ischemia (c-statistic 0.763 versus 0.596, pdiff < 0.05 and 0.770 versus 0.645, pdiff < 0.05, NRI 0.84, p = 0.001 and 0.96, p < 0.001, respectively). Conclusions CAVi exhibits incremental value to predict both abnormal stress MBF and ischemia over CCTA alone. Key Points • Coronary artery volume indexed to left myocardial mass (CAVi), derived from coronary computed tomography angiography (CCTA), is correlated with myocardial blood flow indices derived from13N-ammonia positron emission tomography myocardial perfusion imaging. • CAVi is independently associated with abnormal stress myocardial blood flow. • CAVi provides incremental diagnostic value over CCTA for both abnormal stress MBF and ischemia.

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