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The International Journal of Cardiovascular Imaging

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01.11.2019 | Original Paper

Evaluation of computed tomography myocardial perfusion in women with angina and no obstructive coronary artery disease

verfasst von: Daria Frestad Bechsgaard, Ida Gustafsson, Marie Mide Michelsen, Naja Dam Mygind, Kristoffer Flintholm Raft, Jesper James Linde, Klaus Fuglsang Kofoed, Fay Yu-Huei Lin, James K. Min, Eva Prescott, Jens Dahlgaard Hove

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 2/2020

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Abstract

Women with angina and no obstructive coronary artery disease (CAD) have worse cardiovascular prognosis than asymptomatic women. Limitation in myocardial perfusion caused by coronary microvascular dysfunction (CMD) is one of the proposed mechanisms contributing to the adverse prognosis. The aim of this study was to assess myocardial perfusion in symptomatic women with no obstructive CAD suspected for CMD compared with asymptomatic sex-matched controls using static CT perfusion (CTP). We performed a semi-quantitative assessment of the left ventricular myocardial perfusion and myocardial perfusion reserve (MPR), using static CTP with adenosine provocation, in 105 female patients with angina and no obstructive CAD (< 50% stenosis) and 33 sex-matched controls without a history of angina or ischemic heart disease. Patients were on average 4 years older (p = 0.04) and had a higher burden of cardiovascular risk factors. While global perfusion during rest was comparable between the groups (age-adjusted p = 0.12), global perfusion during hyperemia was significantly reduced in patients compared with controls (163 ± 23 HU vs. 171 ± 25 HU; age-adjusted p = 0.023). The ability to increase myocardial perfusion during adenosine-induced vasodilation was significantly diminished in patients (MPR 148% vs. 158%; age-adjusted p < 0.001). This remained unchanged after adjustment for cardiovascular risk factors (p = 0.008). Women with angina and no obstructive CAD have reduced hyperemic myocardial perfusion and MPR compared with sex-matched controls. Impaired myocardial perfusion may be related to the presence of CMD in some of these women.

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Titel: Evaluation of computed tomography myocardial perfusion in women with angina and no obstructive coronary artery disease
verfasst von: Daria Frestad Bechsgaard
Ida Gustafsson
Marie Mide Michelsen
Naja Dam Mygind
Kristoffer Flintholm Raft
Jesper James Linde
Klaus Fuglsang Kofoed
Fay Yu-Huei Lin
James K. Min
Eva Prescott
Jens Dahlgaard Hove
Publikationsdatum: 01.11.2019
Verlag: Springer Netherlands
Erschienen in: The International Journal of Cardiovascular Imaging / Ausgabe 2/2020
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-019-01723-5

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