scholarly journals DIAGNOSTIC ACCURACY OF QUANTITATIVE H215O PET MEASUREMENTS OF HYPEREMIC MYOCARDIAL BLOOD FLOW VERSUS CORONARY FLOW RESERVE FOR THE DETECTION OF OBSTRUCTIVE CORONARY ARTERY DISEASE

2012 ◽  
Vol 59 (13) ◽  
pp. E1312 ◽  
Author(s):  
Ibrahim Danad ◽  
Pieter G. Raijmakers ◽  
Yolande Appelman ◽  
Hendrik Harms ◽  
Mark Lubberink ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Myocardial Blood Flow ◽  
Coronary Flow ◽  
Obstructive Coronary Artery Disease ◽  
Flow Reserve ◽  
Artery Disease ◽  
H215o Pet

The detection of multivessel coronary artery disease: the value of quantitative myocardial blood flow and coronary flow reserve assessment

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Zavadovskiy ◽  
A Mochula ◽  
A Maltseva ◽  
A Boshchenko ◽  
A Baev ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Blood Flow ◽  
Coronary Flow ◽  
Multivessel Coronary Artery Disease ◽  
Czt Camera ◽  
Flow Reserve ◽  
Artery Disease

Abstract Background/Introduction The recent Cadmium-Zinc-Telluride (CZT) camera for MPS allows evaluating absolute MBF and CFR, possibly increasing the accuracy in detecting of multivessel CAD. Purpose To evaluate the accuracy of myocardial blood flow (MBF) and coronary flow reserve (CFR) quantitation performed by myocardial perfusion scintigraphy (MPS) for the detection of multivessel coronary artery disease (CAD). Methods Fifty-two patients with suspected or known CAD were enrolled in the study. All patients underwent CZT MPS, with the evaluation of MBF and CFR, followed by invasive coronary angiography. According to MPS and coronary angiography results, patients were divided into three groups. 1) non-obstructive CAD and normal MPS scan (control group) (n=7), 2) one vessel disease (1VD) (n=16), with significant coronary stenosis (≥70%) in one major epicardial coronary artery, 3) multivessel disease (MVD) group (n=29), with two or more major epicardial coronary arteries with (≥70%) stenoses or with ≥50% LMA stenosis. Results Absolute MBF and CFR were significantly reduced in patients with MVD as compared to those with 1VD [0.93 (IQR 0.76; 1.39) vs 1.94 (1.37; 2.21) ml/min/g, p=0.00012] and [1.4 (IQR 1.02; 1.85) vs 2.3 (1.8; 2.67), p=0.0004], respectively. The Syntax score correlated with global stress MBF (ρ=−0.64; p<0.0001) and CFR (ρ=−0.53; p=0.0003). ROC analysis showed higher sensitivity and specificity for stress MBF (85.2% and 81%), and CFR (88.9% and 80%) compared with semiquantitative MPS stress evaluation (69% and 69%). Multivariate regression analysis showed that only stress MBF [OR (95% CI) 0.59 (0.42–0.82); p<0.0003] was an independent predictor of MVD. Conclusion The use of absolute myocardial blood flow analysis with the CZT camera may identify high risk patients, such as those with multivessel disease. This approach could be used in clinical practice, increasing the accuracy in the evaluation of patients with known or suspected coronary artery disease. Funding Acknowledgement Type of funding source: None

Low coronary flow relative to myocardial mass predicts heart failure in symptomatic hypertensive patients with no obstructive coronary artery disease

2021 ◽  
Author(s):  
Jenifer M Brown ◽  
Wunan Zhou ◽  
Brittany Weber ◽  
Sanjay Divakaran ◽  
Leanne Barrett ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Obstructive Coronary Artery Disease ◽  
Mass Ratio ◽  
Metabolic Demand ◽  
Myocardial Mass ◽  
Lv Mass ◽  
Artery Disease

Abstract Aims The transition from hypertension to heart failure (HF) remains poorly understood. We hypothesized that insufficient perfusion to match global metabolic demand, reflected by a low ratio of myocardial blood flow to global myocardial mass, may be a HF risk marker. Methods and results A retrospective cohort (n = 346) of patients with hypertension who underwent clinical positron emission tomography (PET) myocardial perfusion imaging for chest pain and/or dyspnoea at Brigham and Women’s Hospital (Boston, MA, USA) were studied. Patients without obstructive coronary artery disease by history or PET perfusion (summed stress score <3), HF, cardiomyopathy, or ejection fraction (EF) <40% were followed for HF hospitalization (primary outcome), all-cause death, and their composite. Myocardial blood flow, left ventricular (LV) mass, volumes, and EF were obtained from PET, and a ‘flow/mass ratio’ was determined as hyperaemic myocardial blood flow over LV mass indexed to body surface area. A lower flow/mass ratio was independently associated with larger end-diastolic (β = −0.44, P < 0.001) and end-systolic volume (β = −0.48, P < 0.001) and lower EF (β = 0.33, P < 0.001). A flow/mass ratio below the median was associated with an adjusted hazard ratio of 2.47 [95% confidence interval (CI) 1.24–4.93; P = 0.01] for HF hospitalization, 1.95 (95% CI 1.12–3.41; P = 0.02) for death, and 2.20 (95% CI 1.39–3.49; P < 0.001) for the composite. Conclusion An integrated physiological measure of insufficient myocardial perfusion to match global metabolic demand identifies subclinical hypertensive heart disease and elevated risk of HF and death in symptomatic patients with hypertension but without flow-limiting coronary artery disease.

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