Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
The International Journal of Cardiovascular Imaging
Erschienen in: The International Journal of Cardiovascular Imaging 9/2018

20.04.2018 | Original Paper

Myocardial flow reserve derived by dynamic perfusion single-photon emission computed tomography reflects the severity of coronary atherosclerosis

verfasst von: Nobuo Iguchi, Yuko Utanohara, Yasuhiro Suzuki, Makoto Suzuki, Kenichi Hagiya, Ryosuke Higuchi, Itaru Takamisawa, Tetsuya Tobaru, Tetsuya Sumiyoshi, Mitsuaki Isobe

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 9/2018

Einloggen, um Zugang zu erhalten

Abstract

A novel single-photon emission computed tomography (SPECT) camera was developed to evaluate dynamic myocardial perfusion flow. However, it is unclear whether myocardial flow reserve (MFR) derived by dynamic perfusion SPECT using the novel SPECT camera (D-SPECT) reflects the severity of coronary atherosclerosis. In the present study, we therefore examined the relationship between MFR using D-SPECT and severity of coronary lesions. The study population comprised 40 patients who underwent both a myocardial dynamic perfusion SPECT study and invasive coronary angiography. The severity of coronary atherosclerosis was evaluated using the Gensini score. All patients underwent a rest/stress SPECT imaging protocol using Tc-99m-sestamibi, and dynamic acquisition was performed. Stress and rest flow was evaluated, and the global and regional MFR was calculated. Global MFR showed a significant negative correlation with Gensini score (r = − 0.345, p = 0.037). Multiple linear regression analysis showed that only global MFR was independently related to Gensini score (p = 0.018). Regional MFR was significantly lower in regions with  90% ≤ stenotic lesions compared with regions with < 90% stenotic lesions (p = 0.009). Global MFR derived by dynamic perfusion SPECT using D-SPECT reflects the severity of coronary atherosclerosis. Further, regional MFR is modulated by severe coronary artery stenotic lesions.
Literatur
1.
Beller GA, Zaret BL (2000) Contributions of nuclear cardiology to diagnosis and prognosis of patients with coronary artery disease. Circulation 101(12):1465–1478CrossRefPubMed
2.
Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA et al (1998) Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation 97(6):535–543CrossRefPubMed
3.
Shaw LJ, Berman DS, Maron DJ, Mancini GB, Hayes SW, Hartigan PM et al (2008) Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy. Circulation 117(10):1283–1291CrossRefPubMed
4.
Berman DS, Kang X, Slomka PJ, Gerlach J, de Yang L, Hayes SW et al (2007) Underestimation of extent of ischemia by gated SPECT myocardial perfusion imaging in patients with left main coronary artery disease. J Nucl Cardiol 14(4):521–528CrossRefPubMed
5.
Herzog BA, Husmann L, Valenta I, Gaemperli O, Siegrist PT, Tay FM et al (2009) Long-term prognostic value of 13N-ammonia myocardial perfusion positron emission tomography added value of coronary flow reserve. J Am Coll Cardiol 54(2):150–156CrossRefPubMed
6.
Hutchins GD, Schwaiger M, Rosenspire KC, Krivokapich J, Schelbert H, Kuhl DE (1990) Noninvasive quantification of regional blood flow in the human heart using N-13 ammonia and dynamic positron emission tomographic imaging. J Am Coll Cardiol 15(5):1032–1042CrossRefPubMed
7.
Gaibazzi N, Rigo F, Lorenzoni V, Molinaro S, Bartolomucci F, Reverberi C et al (2013) Comparative prediction of cardiac events by wall motion, wall motion plus coronary flow reserve, or myocardial perfusion analysis: a multicenter study of contrast stress echocardiography. JACC Cardiovasc Imaging 6(1):1–12CrossRefPubMed
8.
Nemes A, Forster T, Geleijnse ML, Soliman OI, Cate FJ, Csanady M (2008) Prognostic role of aortic atherosclerosis and coronary flow reserve in patients with suspected coronary artery disease. Int J Cardiol 131(1):45–50CrossRefPubMed
9.
Van Herck PL, Paelinck BP, Haine SE, Claeys MJ, Miljoen H, Bosmans JM et al (2013) Impaired coronary flow reserve after a recent myocardial infarction: correlation with infarct size and extent of microvascular obstruction. Int J Cardiol 167(2):351–356CrossRefPubMed
10.
Murthy VL, Naya M, Taqueti VR, Foster CR, Gaber M, Hainer J et al (2014) Effects of sex on coronary microvascular dysfunction and cardiac outcomes. Circulation 129(24):2518–2527CrossRefPubMedPubMedCentral
11.
Park CS, Youn HJ, Kim JH, Cho EJ, Jung HO, Jeon HK et al (2006) Relation between peripheral vascular endothelial function and coronary flow reserve in patients with chest pain and normal coronary angiogram. Int J Cardiol 113(1):118–120CrossRefPubMed
12.
D’Andrea A, Caso P, Cuomo S, Scotto di Uccio F, Scarafile R, Salerno G et al (2007) Myocardial and vascular dysfunction in systemic sclerosis: the potential role of noninvasive assessment in asymptomatic patients. Int J Cardiol 121(3):298–301CrossRefPubMed
13.
Erlandsson K, Kacperski K, van Gramberg D, Hutton BF (2009) Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology. Phys Med Biol 54(9):2635–2649CrossRefPubMed
14.
Gambhir SS, Berman DS, Ziffer J, Nagler M, Sandler M, Patton J et al (2009) A novel high-sensitivity rapid-acquisition single-photon cardiac imaging camera. J Nucl Med 50(4):635–643CrossRefPubMed
15.
Sharir T, Ben-Haim S, Merzon K, Prochorov V, Dickman D, Berman DS (2008) High-speed myocardial perfusion imaging initial clinical comparison with conventional dual detector anger camera imaging. JACC Cardiovasc Imaging 1(2):156–163CrossRefPubMed
16.
Ben-Haim S, Murthy VL, Breault C, Allie R, Sitek A, Roth N et al (2013) Quantification of myocardial perfusion reserve using dynamic SPECT imaging in humans: a feasibility study. J Nucl Med 54(6):873–879CrossRefPubMedPubMedCentral
17.
Shiraishi S, Sakamoto F, Tsuda N, Yoshida M, Tomiguchi S, Utsunomiya D et al (2015) Prediction of left main or 3-vessel disease using myocardial perfusion reserve on dynamic thallium-201 single-photon emission computed tomography with a semiconductor gamma camera. Circulation 79(3):623–631CrossRef
18.
Slomka PJ, Alexanderson E, Jacome R, Jimenez M, Romero E, Meave A et al (2012) Comparison of clinical tools for measurements of regional stress and rest myocardial blood flow assessed with 13N-ammonia PET/CT. J Nucl Med 53(2):171–181CrossRefPubMed
19.
Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105(4):539–542CrossRefPubMed
20.
Gensini GG (1983) A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 51(3):606CrossRefPubMed
21.
Johnson NP, Gould KL (2012) Integrating noninvasive absolute flow, coronary flow reserve, and ischemic thresholds into a comprehensive map of physiological severity. JACC Cardiovasc Imaging 5(4):430–440CrossRefPubMed
22.
Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS et al (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51(4 Suppl):5–40CrossRefPubMed
23.
Uren NG, Melin JA, De Bruyne B, Wijns W, Baudhuin T, Camici PG (1994) Relation between myocardial blood flow and the severity of coronary-artery stenosis. N Engl J Med 330(25):1782–1788CrossRefPubMed
24.
Di Carli M, Czernin J, Hoh CK, Gerbaudo VH, Brunken RC, Huang SC et al (1995) Relation among stenosis severity, myocardial blood flow, and flow reserve in patients with coronary artery disease. Circulation 91(7):1944–1951CrossRefPubMed
25.
Naya M, Tamaki N, Tsutsui H (2015) Coronary flow reserve estimated by positron emission tomography to diagnose significant coronary artery disease and predict cardiac events. Circulation 79(1):15–23CrossRef
26.
Taqueti VR, Everett BM, Murthy VL, Gaber M, Foster CR, Hainer J et al (2015) Interaction of impaired coronary flow reserve and cardiomyocyte injury on adverse cardiovascular outcomes in patients without overt coronary artery disease. Circulation 131(6):528–535CrossRefPubMed
27.
De Bruyne B, Fearon WF, Pijls NH, Barbato E, Tonino P, Piroth Z et al (2014) Fractional flow reserve-guided PCI for stable coronary artery disease. N Engl J Med 371(13):1208–1217CrossRefPubMed
28.
Pijls NH (2013) Fractional flow reserve to guide coronary revascularization. Circulation 77(3):561–569CrossRef
29.
Echavarria-Pinto M, Escaned J, Macias E, Medina M, Gonzalo N, Petraco R et al (2013) Disturbed coronary hemodynamics in vessels with intermediate stenoses evaluated with fractional flow reserve: a combined analysis of epicardial and microcirculatory involvement in ischemic heart disease. Circulation 128(24):2557–2566CrossRefPubMed
30.
Klocke FJ (1987) Measurements of coronary flow reserve: defining pathophysiology versus making decisions about patient care. Circulation 76(6):1183–1189CrossRefPubMed
Metadaten
Titel
Myocardial flow reserve derived by dynamic perfusion single-photon emission computed tomography reflects the severity of coronary atherosclerosis
verfasst von
Nobuo Iguchi
Yuko Utanohara
Yasuhiro Suzuki
Makoto Suzuki
Kenichi Hagiya
Ryosuke Higuchi
Itaru Takamisawa
Tetsuya Tobaru
Tetsuya Sumiyoshi
Mitsuaki Isobe
Publikationsdatum
20.04.2018
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 9/2018
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-018-1358-5

Weitere Artikel der Ausgabe 9/2018

The International Journal of Cardiovascular Imaging 9/2018 Zur Ausgabe

Original Paper

Patient-related factors influencing detectability of coronary arteries in 320-row CT angiography in infants with complex congenital heart disease

Original Paper

Echocardiographic measurements of epicardial adipose tissue and comparative ability to predict adverse cardiovascular outcomes in patients with coronary artery disease

Original Paper

Left atrial deformation as a potent predictor for paroxysmal atrial fibrillation in patients with end-stage renal disease

Original Paper

Optimizing right ventricular focused four-chamber views using three-dimensional imaging, a comparative magnetic resonance based study

Original Paper

Investigation of circle of Willis variants and hemodynamic parameters in twins using transcranial color-coded Doppler sonography

Original Paper

Paclitaxel-coated balloon treatment for functionally nonsignificant residual coronary lesions after balloon angioplasty

Neu im Fachgebiet Kardiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise