Absolute myocardial blood flows derived by dynamic CZT scan vs invasive fractional flow reserve: Correlation and accuracy.
Aged
Cadmium
Coronary Angiography
Coronary Artery Disease
/ diagnostic imaging
Coronary Circulation
/ physiology
Exercise Test
Female
Fractional Flow Reserve, Myocardial
/ physiology
Humans
Male
Middle Aged
Myocardial Perfusion Imaging
Predictive Value of Tests
ROC Curve
Radiopharmaceuticals
Severity of Illness Index
Technetium Tc 99m Sestamibi
Tellurium
Tomography, Emission-Computed, Single-Photon
Zinc
Absolute myocardial blood flow
CZT camera
coronary flow reserve
fractional flow reserve
Journal
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
ISSN: 1532-6551
Titre abrégé: J Nucl Cardiol
Pays: United States
ID NLM: 9423534
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
02
11
2018
accepted:
21
02
2019
pubmed:
9
3
2019
medline:
15
12
2021
entrez:
9
3
2019
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 30847856
doi: 10.1007/s12350-019-01678-z
pii: 10.1007/s12350-019-01678-z
doi:
Substances chimiques
CdZnTe
0
Radiopharmaceuticals
0
Cadmium
00BH33GNGH
Technetium Tc 99m Sestamibi
971Z4W1S09
Zinc
J41CSQ7QDS
Tellurium
NQA0O090ZJ
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
249-259Commentaires et corrections
Type : CommentIn
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