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01.08.2012 | Original Article

Does quantification of myocardial flow reserve using rubidium-82 positron emission tomography facilitate detection of multivessel coronary artery disease?

verfasst von: Maria C. Ziadi, MD, Robert A. deKemp, PhD, Kathryn Williams, MS, Ann Guo, MEng, Jennifer M. Renaud, MSc, Benjamin J. W. Chow, MD, FRCPC, Ran Klein, PhD, FACC, Terrence D. Ruddy, MD, FRCPC, FACC, May Aung, CNMT, Linda Garrard, RN, BScN, Rob S. B. Beanlands, MD, FACC, FRCPC

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 4/2012

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Abstract

Background

Relative myocardial perfusion imaging (MPI) is the standard imaging approach for the diagnosis and prognostic work-up of coronary artery disease (CAD). However, this technique may underestimate the extent of disease in patients with 3-vessel CAD. Positron emission tomography (PET) is also able to quantify myocardial blood flow. Rubidium-82 (⁸²Rb) is a valid PET tracer alternative in centers that lack a cyclotron. The aim of this study was to assess whether assessment of myocardial flow reserve (MFR) measured with ⁸²Rb PET is an independent predictor of severe obstructive 3-vessel CAD.

Methods

We enrolled a cohort of 120 consecutive patients referred to a dipyridamole ⁸²Rb PET MPI for evaluation of ischemia neither with prior coronary artery bypass graft nor with recent percutaneous coronary intervention that also underwent coronary angiogram within 6 months of the PET study. Patients with and without 3-vessel CAD were compared.

Results

Among patients with severe 3-vessel CAD, MFR was globally reduced (<2) in 88% (22/25). On the adjusted logistic Cox model, MFR was an independent predictor of 3-vessel CAD [.5 unit decrease, HR: 2.1, 95% CI (1.2-3.8); P = .015]. The incremental value of ⁸²Rb MFR over the SSS was also shown by comparing the adjusted SSS models with and without ⁸²Rb MFR (P = .005).

Conclusion

⁸²Rb MFR is an independent predictor of 3-vessel CAD and provided added value to relative MPI. Clinical integration of this approach should be considered to enhance detection and risk assessment of patients with known or suspected CAD.

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Titel: Does quantification of myocardial flow reserve using rubidium-82 positron emission tomography facilitate detection of multivessel coronary artery disease?
verfasst von: Maria C. Ziadi, MD
Robert A. deKemp, PhD
Kathryn Williams, MS
Ann Guo, MEng
Jennifer M. Renaud, MSc
Benjamin J. W. Chow, MD, FRCPC
Ran Klein, PhD, FACC
Terrence D. Ruddy, MD, FRCPC, FACC
May Aung, CNMT
Linda Garrard, RN, BScN
Rob S. B. Beanlands, MD, FACC, FRCPC
Publikationsdatum: 01.08.2012
Verlag: Springer-Verlag
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 4/2012
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-011-9506-5

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Does quantification of myocardial flow reserve using rubidium-82 positron emission tomography facilitate detection of multivessel coronary artery disease?