Absolute myocardial blood flows derived by dynamic CZT scan vs invasive fractional flow reserve: Correlation and accuracy

Autor: Alessia Gimelli, Alla A. Boshchenko, Riccardo Liga, A Mochula, A. Baev, K. V. Zavadovsky, Alexander L. Krylov, Evgeny Nesterov, Alexander V. Vrublevsky, Marina O. Gulya
Rok vydání: 2019
Předmět:
Male
Technetium Tc 99m Sestamibi
medicine.medical_specialty
coronary flow reserve
Coronary Artery Disease
Fractional flow reserve
030204 cardiovascular system & hematology
Coronary Angiography
Severity of Illness Index
Absolute myocardial blood flow
030218 nuclear medicine & medical imaging
Correlation
03 medical and health sciences
Myocardial perfusion imaging
0302 clinical medicine
Predictive Value of Tests
Coronary Circulation
Internal medicine
CZT camera
Stable cad
medicine
Humans
Radiology
Nuclear Medicine and imaging
fractional flow reserve
Aged
Tomography
Emission-Computed
Single-Photon
medicine.diagnostic_test
business.industry
Myocardial Perfusion Imaging
Coronary flow reserve
Blood flow
Middle Aged
medicine.disease
Fractional Flow Reserve
Myocardial
Invasive coronary angiography
Zinc
Stenosis
ROC Curve
Exercise Test
Cardiology
Female
Radiopharmaceuticals
Tellurium
Cardiology and Cardiovascular Medicine
business
Cadmium
Zdroj: Journal of Nuclear Cardiology. 28:249-259
ISSN: 1532-6551
1071-3581
Popis: To define the diagnostic power of absolute myocardial blood flow (MBF) evaluation on dynamic CZT imaging in intermediate risk patients in comparison with invasive coronary angiography (ICA) and fractional flow reserve (FFR). Twenty-three stable CAD patients underwent one-day dynamic rest-stress 99mTc-Sestamibi myocardial perfusion imaging by CZT camera. Stress and rest MBF values were calculated semi-automatically using a net retention model by Leppo. Coronary flow reserve (CFR) and flow difference (FD) [MBF stress − MBF rest] were also estimated. A total of 28 vessels were functionally quantified with FFR: 19 (68%) vessels with a stenosis ≥ 70% and 9 (32%) with < 70% stenotic lesions. The mean global MBFs at rest and during stress were 0.36 (IQR 0.33-0.54) mL/min/g and 0.67 (IQR 0.55-0.81) mL/min/g, respectively, with an average CFR of 1.80 (IQR 1.35-2.24). Moderate correlations between stenosis severity and FFR (r = 0.45; P = .01), stress MBF (r = −0.46; P = .01) and FD (r = −0.37; P = .04) were detected. FFR abnormalities were best predicted by absolute stress MBF, CFR and FD with values of ≤ 0.54 mL/min/g (sensitivity 61.5%; specificity 93.3%), ≤ 1.48 (sensitivity 69.2%; specificity 93.3%) and ≤ 0.18 mL/min/g (sensitivity 69.2%; specificity 100%), respectively. The values of stress MBF, CFR and FD obtained through dynamic CZT acquisitions compare well with invasive FFR. The clinical use of dynamic acquisition of myocardial perfusion imaging by CZT may help cardiologist in the detection of hemodynamically significant CAD.
Databáze: OpenAIRE
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