Clinical significance of corrected relative flow reserve derived from 13N-ammonia positron emission tomography combined with coronary computed tomography angiography

Autor: Hitoshi Miki, Masao Miyagawa, Naoto Kawaguchi, Go Kawamura, Yukio Kazatani, Hideki Okayama, Takeshi Inoue, Go Hiasa, Naoki Fukuyama, Teruhito Kido, Teruhito Mochizuki, Tatsuya Shigematsu
Rok vydání: 2019
Předmět:
Zdroj: Journal of Nuclear Cardiology. 28:1851-1860
ISSN: 1532-6551
1071-3581
Popis: This study evaluated corrected relative flow reserve (RFR) derived from 13N-ammonia positron emission tomography (PET) combined with coronary computed tomography angiography (CTA). We analyzed 61 patients who underwent coronary CTA, 13N-ammonia PET, and invasive coronary angiography. Triple-vessel disease were excluded. Conventional RFRs were calculated as the ratio of hyperemic myocardial blood flow (hMBF) of hypoperfusion areas to those of non-ischemic lesions. Corrected RFRs were calculated using PET and coronary CTA to adjust coronary territories to their feeding vessels. Diagnostic performance was compared to detect obstructive coronary lesions. Of the 180 vessels analyzed, 50 were diagnosed as obstructive lesions (≥ 70% stenosis and/or fractional flow reserve value ≤ 0.8). The coronary flow reserve (CFR), hMBF, conventional RFR, and corrected RFR of obstructive lesions were significantly lower than those of non-obstructive lesions. In receiver operating characteristic curve analysis, these quantitative PET measurements had area under the curve of 0.67, 0.71, 0.89, and 0.92, respectively. Diagnostic performance differences between corrected and conventional RFR were not statistically significant. In patients with single or double vessel disease, indices of RFR, with or without coronary angiographic guidance of the reference coronary territory, are better discriminators of flow-limiting stenoses than hMBF and CFR.
Databáze: OpenAIRE
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