Diagnostic accuracy of stress myocardial computed tomography perfusion imaging to detect myocardial ischemia: a comparison with coronary flow velocity reserve derived from transthoracic Doppler echocardiography.
Adenosine Triphosphate
Aged
Area Under Curve
Blood Flow Velocity
Coronary Circulation
/ physiology
Coronary Vessels
/ diagnostic imaging
Echocardiography, Doppler
/ methods
Female
Humans
Male
Middle Aged
Myocardial Ischemia
/ diagnostic imaging
Myocardial Perfusion Imaging
/ methods
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Tomography, X-Ray Computed
/ methods
Coronary flow velocity reserve
Dynamic myocardial computed tomography perfusion
Myocardial ischemia
Stress myocardial blood flow
Journal
Journal of cardiology
ISSN: 1876-4738
Titre abrégé: J Cardiol
Pays: Netherlands
ID NLM: 8804703
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
27
12
2019
revised:
05
03
2020
accepted:
06
03
2020
pubmed:
2
5
2020
medline:
18
5
2021
entrez:
2
5
2020
Statut:
ppublish
Résumé
Our aim was to evaluate the ability of adenosine triphosphate (ATP)-stress myocardial computed tomography perfusion (CTP) imaging to detect myocardial ischemia in the left anterior descending artery (LAD) territory, and to compare this method with coronary flow velocity reserve (CFVR) measured by transthoracic Doppler echocardiography (TTDE). ATP-stress CTP and CFVR were performed in 50 patients with stable angina pectoris. Myocardial ischemia assessed from CTP imaging was defined as qualitative visual perfusion defects and reduced myocardial blood flow (MBF) based on quantitative assessment. A cut-off value of CFVR of 2.0 was used. The mean CFVR was 1.9 ± 0.6 in ischemic regions by CTP, whereas it was 2.9 ± 0.8 in non-ischemic regions (p < 0.001). CTP imaging could accurately predict CFVR <2.0 with 84.0% diagnostic accuracy (94.7% sensitivity, 77.4% specificity, 72.0% positive predictive value, and 96.0% negative predictive value). When receiver operating characteristic curve analysis of the MBF data was performed to detect CFVR <2.0, the area under the curve was 0.89, and the optimal MBF cut-off value was 1.43 mL/g/min. This study suggests that qualitative and quantitative assessment of ATP-stress CTP exhibits a good correlation with CFVR for evaluation of myocardial ischemia.
Sections du résumé
BACKGROUND
Our aim was to evaluate the ability of adenosine triphosphate (ATP)-stress myocardial computed tomography perfusion (CTP) imaging to detect myocardial ischemia in the left anterior descending artery (LAD) territory, and to compare this method with coronary flow velocity reserve (CFVR) measured by transthoracic Doppler echocardiography (TTDE).
METHODS
ATP-stress CTP and CFVR were performed in 50 patients with stable angina pectoris. Myocardial ischemia assessed from CTP imaging was defined as qualitative visual perfusion defects and reduced myocardial blood flow (MBF) based on quantitative assessment. A cut-off value of CFVR of 2.0 was used.
RESULTS
The mean CFVR was 1.9 ± 0.6 in ischemic regions by CTP, whereas it was 2.9 ± 0.8 in non-ischemic regions (p < 0.001). CTP imaging could accurately predict CFVR <2.0 with 84.0% diagnostic accuracy (94.7% sensitivity, 77.4% specificity, 72.0% positive predictive value, and 96.0% negative predictive value). When receiver operating characteristic curve analysis of the MBF data was performed to detect CFVR <2.0, the area under the curve was 0.89, and the optimal MBF cut-off value was 1.43 mL/g/min.
CONCLUSIONS
This study suggests that qualitative and quantitative assessment of ATP-stress CTP exhibits a good correlation with CFVR for evaluation of myocardial ischemia.
Identifiants
pubmed: 32354493
pii: S0914-5087(20)30093-9
doi: 10.1016/j.jjcc.2020.03.003
pii:
doi:
Substances chimiques
Adenosine Triphosphate
8L70Q75FXE
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
251-258Informations de copyright
Copyright © 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.