Coronary Flow Reserve
Diagnostic value of blood flow reserve measurement with 13N-NH3·H2O PET/CT imaging in patients with coronary microvascular disease
Kun Peng, Weiqiang Chen, Yongde Wang, Jian Zhang, Jianming Li
Published 2019-12-25
Cite as Chin J Nucl Med Mol Imaging, 2019, 39(12): 708-713. DOI: 10.3760/cma.j.issn.2095-2848.2019.12.002
Abstract
ObjectiveTo evaluate the diagnostic value of coronary flow reserve (CFR) on 13N-NH3·H2O PET/CT imaging for patients with suspected coronary microvascular disease (CMVD).
MethodsFrom September 2017 to September 2018, 54 clinical suspected CMVD patients (22 males, 32 females; age: 25-77 years) in TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients underwent 13N-NH3·H2O PET/CT imaging to measure left ventricle CFR (LV-CFR), and were divided into CMVD group (LV-CFR<2.5) and non-CMVD group (LV-CFR≥2.5). Semi-quantitative parameters of PET/CT myocardial perfusion imaging (MPI), including summed stress score (SSS), summed rest score (SRS), summed difference score (SDS) and transient ischemic dilation (TID), as well as left ventricular function parameters, such as rest and stress imaging left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) were compared between two groups. Besides, rest and stress LV-myocardial blood flow (MBF) and CFR distribution of the CMVD group in the region of three coronary arteries was also analyzed and compared. Independent-sample t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze the data.
ResultsRest LV-MBF of CMVD group was higher than that of non-CMVD group ((0.74±0.16) vs (0.63±0.09) ml·g-1·min-1) and stress LV-MBF was lower ((1.52±0.36) vs (1.89±0.22) ml·g-1·min-1; t values: 2.925, -4.503, both P<0.05). There was no significant difference between the two groups in other semi-quantitative parameters (t values: from -1.430 to 1.400, U values: 286.0-338.5, all P>0.05). Positive correlations were found in CFR among left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) (r values: 0.798-0.836, all P<0.01).
ConclusionCFR measured with PET/CT imaging is better than semi-quantitative parameters in MPI, which provides noninvasive and objective diagnosis and evaluation information for patients without obvious epicardial coronary artery stenosis and suspected with CMVD.
Key words:
Coronary artery disease; Microvascular angina; Fractional flow reserve, myocardial; Myocardial perfusion imaging; Positron-emission tomography; Tomography, X-ray computed; Ammonia
Contributor Information
Kun Peng
Department of Nuclear Medicine, TEDA International Cardiovascular Hospital and Tianjin Medical University Cardiovascular Clinical Institute, Tianjin 300457, China
Weiqiang Chen
Department of Cardiology, TEDA International Cardiovascular Hospital and Tianjin Medical University Cardiovascular Clinical Institute, Tianjin 300457, China
Yongde Wang
Department of Cardiology, TEDA International Cardiovascular Hospital and Tianjin Medical University Cardiovascular Clinical Institute, Tianjin 300457, China
Jian Zhang
Department of Cardiology, TEDA International Cardiovascular Hospital and Tianjin Medical University Cardiovascular Clinical Institute, Tianjin 300457, China
Jianming Li
Department of Nuclear Medicine, TEDA International Cardiovascular Hospital and Tianjin Medical University Cardiovascular Clinical Institute, Tianjin 300457, China
