[15O]H2O myocardial perfusion positron emission tomography: Added value of relative stress perfusion deficit in the prediction of significant coronary artery stenosis in a mixed population

被引:2
作者
Mark, Peter D. [1 ]
Prescott, Eva [2 ,3 ]
Marner, Lisbeth [1 ,3 ]
Hovind, Peter [1 ]
Krakauer, Martin [1 ]
机构
[1] Copenhagen Univ Hosp, Bispebjerg Frederiksberg Hosp, Dept Clin Physiol & Nucl Med, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark
[2] Copenhagen Univ Hosp, Bispebjerg Frederiksberg Hosp, Dept Cardiol, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark
[3] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark
关键词
O-15]H2O PET; Myocardial perfusion imaging; Total perfusion deficit; Relative flow reserve; FLOW RESERVE; PET; SPECT;
D O I
10.1016/j.nuclcard.2024.101880
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: It remains unknown whether estimation of the relative stress perfusion deficit offers added value in the prediction of significant coronary artery stenosis in myocardial perfusion imaging with [O-15]H2O positron emission tomography (PET) in a population with high prevalence of established cardiac disease. Methods: During eight months, we consecutively included all patients undergoing [O-15]H2O PET and subsequent invasive coronary angiography (ICA). Significant stenosis was defined from ICA as fractional flow reserve <=.8 or coronary artery narrowing of >= 70%. We calculated absolute and relative total perfusion deficits (aTPD and rTPD, respectively) as semiquantitative measures of the extent and severity of reduced stress perfusion. A multivariate logistic regression analysis was performed to test the adjusted associations (odds ratio (OR) with 95% CI) with significant coronary artery stenosis. Results: Of 800 patients undergoing [O-15]H2O PET, 144 underwent ICA, where 142 patients had aTPD of >= 3% and 79 (55%) of these had at least one significant stenosis. In an adjusted analysis, rTPD (OR10% increase = 2.12 (1.44-3.12), P < .001), previous coronary artery bypass grafting (CABG) (OR = .11 (.03-.36), P < .001) and reduced left ventricular ejection fraction (LVEF) (OR = .25 (.08-.84), P = .02) were independently associated with significant stenosis, whereas the association with aTPD (OR10% increase = 1.14 (.98-1.32), P = .08) was modest. Conclusions: In the presence of an absolute perfusion deficit (aTPD of >= 3%), rTPD may improve the prediction of significant stenosis in a heterogeneous population of patients examined with [O-15]H2O PET. Furthermore, previous CABG and reduced LVEF are associated with nonstenotic perfusion deficiencies, suggesting caution when interpreting myocardial perfusion imaging in such patients.
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页数:9
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