scholarly journals Discordance between invasive coronary flow reserve (CFR) and non-invasive myocardial flow reserve (MFR) in diffuse coronary ectasia (DCE)

2020 ◽  
Vol 6 (2) ◽  
pp. 20190046
Author(s):  
Mohammed Khalil ◽  
Deniz Alibazoglu ◽  
Cem Numan Balci ◽  
Rawan Hussein ◽  
Abraham Abuwadi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Suspected Coronary Artery Disease ◽  
Myocardial Flow Reserve ◽  
Total Occlusion ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
Coronary Ectasia ◽  
Myocardial Flow

Clinical use with evidence base for diagnostic and prognostic value of quantitative positron emission tomography(PET) myocardial perfusion imaging (MPI) in patients with known or suspected coronary artery disease has exponentially increased over the last decade. This case illustrates the very first time that stress myocardial blood flow(MBF) in absolute terms (ml/min/gram) and myocardial flow reserve(MFR) are augmented in three vessel diffuse coronary ectasia by N13-Ammonia PET MPI. Moreover, relative qualitative MPI demonstrated moderate-sized ischemia in right coronary artery territory with chronic total occlusion in middle segment; despite regional myocardial flow reserve remains above ischemic thresholds while regional stress myocardial blood flow is mildly reduced.

scholarly journals Comparison of the Prognostic Value of Global and Regional Myocardial Flow Capacity Radius, Myocardial Flow Reserve, and Stress Myocardial Blood Flow Using Rubidium-82 with SiPM PET/CT

2021 ◽  
Author(s):  
Matthieu DIETZ ◽  
Christel H Kamani ◽  
Gilles Allenbach ◽  
Vladimir Rubimbura ◽  
Stephane Fournier ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Myocardial Flow Reserve ◽  
Flow Capacity ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
Pet Ct ◽  
Myocardial Flow ◽  
Rubidium 82 ◽  
Regional Myocardial Flow

Abstract Purpose The aim of this study was to assess the most reliable quantitative variable on Rubidium-82 (82Rb) cardiac PET/CT for predicting major adverse cardiovascular events (MACE), on the latest PET camera using silicon photomultipliers digital readout (SiPM) technology. Methods We prospectively enrolled 274 consecutive participants with suspected myocardial ischemia. Participants underwent 82Rb cardiac SiPM PET/CT and were followed-up for MACE over 652 days (interquartile range: 559 to 751 days). For each participant, global and regional myocardial flow reserve (MFR), stress myocardial blood flow (stress MBF) and their combination as myocardial flow capacity radius (MFC radius) were measured. Results On receiver operator curve analysis, MACE prediction was similar for global and regional MFR, stress MBF, and MFC radius (area under the curve; (i) Global: 0.70 vs. 0.71 and 0.73, and (ii) Regional: 0.71 vs. 0.71 and 0.73, respectively, p > 0.1 for all pairwise comparisons). On multivariable analysis, (i) Global: MFR < 1.98, stress MBF < 1.94 mL/g/min, and MFC radius < 3.12, as well as (ii) Regional: MFR < 1.75, stress MBF < 1.75 mL/g/min, and MFC radius < 2.7, emerged all as similar independent predictors of MACE (p < 0.001 for all). Conclusions Using the latest SiPM PET technology with 82Rb, global and regional MFR, stress MBF, and MFC radius are similar powerful predictors of cardiovascular event.

13N-ammonia PET/CT stress myocardial blood flow compared to fractional flow reserve in coronary artery disease

2020 ◽  
Vol 41 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Jouke J. Boer ◽  
Johan J.J.S. Kappelhof ◽  
Friso M. van der Zant ◽  
Maurits Wondergem ◽  
Hans(J) B.R.M. de Swart ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
Pet Ct ◽  
Artery Disease

scholarly journals Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by 13N-ammonia PET Quantitative Myocardial Perfusion

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 628
Author(s):  
Andrea Monroy-Gonzalez ◽  
Erick Alexanderson-Rosas ◽  
Oscar Perez-Orpinel ◽  
Magdalena Dobrolinska ◽  
Rene Tio ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Calcium Score ◽  
Added Value ◽  
Qualitative Assessment ◽  
Significant Stenosis ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
Myocardial Flow ◽  
Transluminal Attenuation Gradient

Transluminal attenuation gradient (TAG) represents the slope of intraluminal contrast that decreases along a coronary vessel during coronary computed tomography angiography (CCTA). The aim of this study was to determine the added value of TAG to qualitative CCTA assessment of significant stenosis (>50%) detecting ischemia as determined by stress myocardial blood flow (MBF) or myocardial flow reserve (MFR) measured by positron emission tomography (PET). Individual contributions of TAG, qualitative assessment and the impact of calcium score were also investigated. Methods: We studied 38 consecutive patients that were referred due to suspected or known coronary artery disease (CAD). All patients underwent a two-phase hybrid 13N-ammonia PET/CT and CCTA. Results: TAG and presence of qualitatively assessed significant stenosis, but not calcium score, were associated with stress myocardial blood flow (MBF) and myocardial flow reserve (MFR). The area under the curves (AUC) of the linear predictor model including qualitative assessment and TAG was superior to the AUC of separate qualitative assessment or TAG for the detection of ischemia according to stress MBF (AUCs were: 88% vs. 79% and 77%; p = 0.01 and p = 0.01, respectively). Conclusions: TAG combined with qualitative CCTA assessment improved ischemia detection.

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