Comparison of empagliflozin and sitagliptin therapy on myocardial perfusion reserve in diabetic patients with coronary artery disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Minyoung Oh ◽  
Joon Ho Choi ◽  
Seon-Ok Kim ◽  
Pil Hyung Lee ◽  
Jung-Min Ahn ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Myocardial Perfusion Reserve ◽  
Diabetic Patients ◽  
Perfusion Reserve ◽  
Artery Disease

Endothelial dysfunction and reduced myocardial perfusion reserve in heart failure secondary to coronary artery disease

2003 ◽  
Vol 91 (4) ◽  
pp. 497-500 ◽  
Author(s):  
Richard M. de Jong ◽  
Paul K. Blanksma ◽  
Jan H. Cornel ◽  
A.d F.M. Van den Heuvel ◽  
Hans-Marc J. Siebelink ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Myocardial Perfusion ◽  
Myocardial Perfusion Reserve ◽  
Perfusion Reserve ◽  
Artery Disease

scholarly journals Temporal Trends in Angina, Myocardial Perfusion, and Left Ventricular Remodeling in Women With No Obstructive Coronary Artery Disease Over 1‐Year Follow‐Up: Results From WISE‐CVD

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Odayme Quesada ◽  
Melody Hermel ◽  
Nissi Suppogu ◽  
Haider Aldiwani ◽  
Chrisandra Shufelt ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Obstructive Coronary Artery Disease ◽  
Myocardial Perfusion Reserve ◽  
Perfusion Reserve ◽  
Myocardial Perfusion Reserve Index ◽  
Lv Mass ◽  
Artery Disease

Background Women with ischemia and no obstructive coronary artery disease are increasingly recognized and found to be at risk for major adverse cardiovascular events. Methods and Results In 214 women with suspected ischemia and no obstructive coronary artery disease who completed baseline and 1‐year follow‐up vasodilatory stress cardiac magnetic resonance imaging, we investigated temporal trends in angina (Seattle Angina Questionnaire [SAQ]), myocardial perfusion reserve index, blood pressure, and left ventricular (LV) remodeling and function from baseline to 1‐year follow‐up and explored associations between these different parameters. We observed concordant positive trends in 4/5 SAQ domains, SAQ‐7, myocardial perfusion reserve index, blood pressure, LV mass, and LV mass‐to‐volume ratio. There was no association between SAQ‐7 improvement and myocardial perfusion reserve index improvement over 1‐year follow‐up ( P =0.1). Higher indexed LV end‐diastolic volume and time to peak filling rate at baseline were associated with increased odds of clinically relevant SAQ‐7 improvement (odds ratio [OR], 1.05; 95% CI, 1.0–1.1; and OR, 2.40; 95% CI, 1.1–5.0, respectively). Hypertension was associated with decreased odds of SAQ‐7 improvement (OR, 0.41; 95% CI, 0.19–0.91). Conclusions In women with ischemia and no obstructive coronary artery disease clinically treated with cardiac medications over 1 year, we observed concurrent temporal trends toward improvement in SAQ, myocardial perfusion reserve index, blood pressure, LV mass, and LV mass‐to volume ratio. We showed that abnormalities in LV morphology and diastolic function at baseline were predictive of clinically significant improvement in angina at follow‐up, whereas history of hypertension was associated with lower odds. Future studies are needed to assess the mechanisms and treatments responsible for the improvements we observed. Registration URL: https://www.clini​caltr​ials.gov ; Unique identifier: NCT02582021.

scholarly journals Prognostic Assessment of Diabetics Using Myocardial Perfusion Imaging: Diabetes Mellitus is Still a Coronary Artery Disease Equivalent

2017 ◽  
Vol 11 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Andrea De Lorenzo ◽  
Victor F. Souza ◽  
Leticia Glerian ◽  
Ronaldo SL Lima
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Diabetic Patients ◽  
Death Rates ◽  
Prognostic Assessment ◽  
Increased Risk ◽  
Risk Condition ◽  
Artery Disease

Background:Even though diabetes mellitus (DM) has been considered a “Coronary Artery Disease (CAD) equivalent”, that is still controversial, especially in a contemporary population subject to optimized treatment.Objective:We aimed to assess the cardiovascular risk of diabetics by myocardial perfusion scintigraphy (MPS).Methods:Consecutive patients who underwent MPS from 2008 to 2012 were studied. Perfusion scores were calculated, and abnormal MPS was defined as a summed stress score >3. Patients were followed for 3±1 years for all-cause death, which was compared between patients with DM (without known CAD) and patients with known CAD but without DM.Results:Among 3409 patients, 471 (13.8%) were diabetics without known CAD (DM group) and 638 (18.7%) had CAD without diabetes (CAD group). Annualized death rates were not significantly different between DM or CAD patients (0.9vs1.5%, p=0.09). With normal MPS, death rates were 0.7% for DM and 0.6% for CAD (p=0.8). With abnormal MPS, death rates increased similarly in the DM and CAD groups.Conclusions:In diabetic patients without known CAD, the rate of death was not significantly different from patients with prior CAD and without DM. Abnormal MPS increased risk similarly in diabetic patients and in those with CAD. These findings suggest that DM may still be considered a high-risk condition, comparable to known CAD, and effectively stratified by MPS.

Abstract 20355: Cardiac Magnetic Resonance Assessment of Absolute Myocardial Blood Flow and Myocardial Perfusion Reserve Compared With FFR in Patients With Coronary Artery Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yoshihisa Kanaji ◽  
Tetsumin Lee ◽  
Tadashi Murai ◽  
Asami Suzuki ◽  
Junji Matsuda ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Cardiac Magnetic Resonance ◽  
Coronary Artery ◽  
Magnetic Resonance ◽  
Myocardial Perfusion Reserve ◽  
Perfusion Reserve ◽  
Artery Disease ◽  
Perfusion Cmr ◽  
Ischemic Segment

Background: The diagnostic value of absolute myocardial blood flow (AMBF) obtained by cardiac magnetic resonance (CMR) quantitative measurement remains uncertain. We evaluated the subendocardial, epicardial, transmural AMBF, and myocardial perfusion reserve (MPR) derived from AMBF determined by perfusion CMR. We also assessed the relationship between CMR-derived AMBF and fractional flow reserve (FFR) in patients with coronary artery disease (CAD). Methods and Results: We investigated 38 CAD patients (mean age, 67±10 years; male, 89%, 46 vessels territories) who underwent perfusion CMR both at stress and rest, and invasive coronary angiography. FFR was measured in all vessels with stenosis more than 40% by QCA. FFR<0.8 was considered hemodynamically significant stenosis. Patients with previous revascularization and/or myocardial infarction, and with renal dysfunction were excluded. We perform quantitative analysis of the transmural, subendocardial and epicardial AMBF, and MPR at mid-ventricular level. AMBF distributed in the wide range both subendocardium and subepicardium. At stress, AMBF was significantly increased in all of the subendocardial, epicardial, and transmural layers of the ischemic segment at adenosine-induced hyperemia from rest AMBF. (At rest: subendocardial 245±122 ml/100g/min, epicardial 124 [75-233] ml/100g/min, transmural 172 [102-261] ml/100mg/min. At stress: subendocardial 380 [156-517] ml/100g/min, epicardial 275 [158-502] ml/100g/mintransmural 287 [152-456] ml/100g/min.) There was a significant relationship between transmural AMBF and FFR, transmural MPR and FFR values, with r = 0.33 (p = 0.028), r=0.39 (p=0.007). The transmural MPR<2.47 threshold yielded a sensitivity of 0.92 (95% confidence interval: 0.77 to 0.99) and a specificity of 0.71 (0.44-0.90) to detect coronary ischemia with a FFR <0.8, and an area under the ROC curve (AUC) of 0.77 (0.62 to 0.88) for vessel-based analysis. Subendocardial AMBF and MPR gradually decreased with decreasing FFR at ischemic segment, but it was not significant. Conclusions: The quantitative analysis of transmural AMBF and myocardial MPR on perfusion cardiac magnetic resonance may predicts hemodynamically significant CAD as defined by FFR.

scholarly journals The Prognostic Significance of Quantitative Myocardial Perfusion: An Artificial Intelligence Based Approach Using Perfusion Mapping

Circulation ◽  
2020 ◽  
Author(s):  
Kristopher D. Knott ◽  
Andreas Seraphim ◽  
Joao B. Augusto ◽  
Hui Xue ◽  
Liza Chacko ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Myocardial Perfusion Reserve ◽  
Prognostic Significance ◽  
Suspected Coronary Artery Disease ◽  
Major Adverse Cardiovascular Events ◽  
Co Morbidity ◽  
Artery Disease

Background: Myocardial perfusion reflects the macro- and microvascular coronary circulation. Recent quantitation developments using cardiovascular magnetic resonance (CMR) perfusion permit automated measurement clinically. We explored the prognostic significance of stress myocardial blood flow (MBF) and myocardial perfusion reserve (MPR, the ratio of stress to rest MBF). Methods: A two center study of patients with both suspected and known coronary artery disease referred clinically for perfusion assessment. Image analysis was performed automatically using a novel artificial intelligence approach deriving global and regional stress and rest MBF and MPR. Cox proportional hazard models adjusting for co-morbidities and CMR parameters sought associations of stress MBF and MPR with death and major adverse cardiovascular events (MACE), including myocardial infarction, stroke, heart failure hospitalization, late (>90 day) revascularization and death. Results: 1049 patients were included with median follow-up 605 (interquartile range 464-814) days. There were 42 (4.0%) deaths and 188 MACE in 174 (16.6%) patients. Stress MBF and MPR were independently associated with both death and MACE. For each 1ml/g/min decrease in stress MBF the adjusted hazard ratio (HR) for death and MACE were 1.93 (95% CI 1.08-3.48, P=0.028) and 2.14 (95% CI 1.58-2.90, P<0.0001) respectively, even after adjusting for age and co-morbidity. For each 1 unit decrease in MPR the adjusted HR for death and MACE were 2.45 (95% CI 1.42-4.24, P=0.001) and 1.74 (95% CI 1.36-2.22, P<0.0001) respectively. In patients without regional perfusion defects on clinical read and no known macrovascular coronary artery disease (n=783), MPR remained independently associated with death and MACE, with stress MBF remaining associated with MACE only. Conclusions: In patients with known or suspected coronary artery disease, reduced MBF and MPR measured automatically inline using artificial intelligence quantification of CMR perfusion mapping provides a strong, independent predictor of adverse cardiovascular outcomes.

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