Myocardial Perfusion PET for the Detection and Reporting of Coronary Microvascular Dysfunction A JACC: Cardiovascular Imaging Expert Panel Statement

被引：90

作者：

Schindler, Thomas H. ^{[1
,31
]}

Fearon, William F. ^{[2
,3
,4
]}

Pelletier-Galarneau, Matthieu ^{[5
]}

Ambrosio, Giuseppe ^{[6
]}

Sechtem, Udo ^{[7
]}

Ruddy, Terrence D. ^{[8
]}

Patel, Krishna K. ^{[9
,10
]}

Bhatt, Deepak L. ^{[11
]}

Bateman, Timothy M. ^{[12
,13
]}

Gewirtz, Henry ^{[14
]}

Shirani, Jamshid ^{[15
]}

Knuuti, Juhani ^{[16
]}

Gropler, Robert J.

Chareonthaitawee, Panithaya ^{[17
]}

Slart, Riemer H. J. A. ^{[18
,19
,20
]}

Windecker, Stephan ^{[21
]}

Kaufmann, Philipp A. ^{[22
]}

Abraham, Maria R. ^{[23
]}

Taqueti, Viviany R. ^{[24
,25
]}

Ford, Thomas J. ^{[26
]}

Camici, Paolo G. ^{[27
,28
]}

Schelbert, Heinrich R. ^{[29
]}

Dilsizian, Vasken ^{[30
]}

机构：

[1] Washington Univ, Mallinckrodt Inst Radiol, Div Nucl Med Cardiovasc, St Louis Sch Med, St Louis, MO USA

[2] Stanford Univ, Div Cardiovasc Med, Sch Med, Stanford, CA USA

[3] Stanford Univ, Cardiovasc Inst, Sch Med, Stanford, CA USA

[4] VA Palo Alto Hlth Care Syst, Palo Alto, CA USA

[5] Montreal Heart Inst, Dept Med Imaging, Montreal, PQ, Canada

[6] Univ Perugia, Sch Med, Osped S Maria della Misericordia Perugia, Perugia, Italy

[7] Cardiologicum Stuttgart, Stuttgart, Germany

[8] Univ Ottawa Heart Inst, Ottawa, ON, Canada

[9] Icahn Sch Med Mt Sinai, New York, NY USA

[10] Michael A Wiener Cardiovasc Inst, New York, NY USA

[11] Mt Sinai Hlth Syst, Mt Sinai Heart, Icahn Sch Med, Mt Sinai Heart, New York, NY USA

[12] St Lukes Hlth Syst, Kansas City, MO USA

[13] Univ Missouri, Midamerica Heart Inst, Kansas City Sch Med, Kansas City, MO USA

[14] Harvard Med Sch, Massachusetts Gen Hosp, Cardiac Div, Boston, MA USA

[15] St Lukes Univ Hlth Network, Cardiol, Bethlehem, PA USA

[16] Turku Univ Hosp, Heart Ctr, Turku, Finland

[17] Mayo Clin, Rochester, MN USA

[18] Univ Groningen, Univ Med Ctr Groningen, Med Imaging Ctr, Dept Radiol, Groningen, Netherlands

[19] Univ Med Ctr Groningen, Univ Groningen, Dept Nucl Med, Groningen, Netherlands

[20] Univ Groningen, Univ Med Ctr Groningen, Dept Mol Imaging, Groningen, Netherlands

[21] Univ Bern, Dept Cardiol Inselspital, Bern, Switzerland

[22] Univ Hosp Zurich, Dept Nucl Med Cardiac Imaging, Zurich, Switzerland

[23] Univ Calif San Francisco, Hypertroph Cardiomyopathy Ctr Excellence, San Francisco, CA USA

[24] Brigham & Womens Hosp, Dept Radiol, Cardiovasc Imaging Program, Boston, MA USA

[25] Brigham & Womens Hosp, Dept Med, Boston, MA USA

[26] Univ Newcastle, Fac Med, Newcastle, Australia

[27] Osped San Raffaele, Milan, Italy

[28] Univ Vita Salute San Raffaele, Milan, Italy

[29] UCLA, David Geffen Sch Med, Dept Mol Imaging & Med Pharmacol, Los Angeles, CA USA

[30] Univ Maryland, Dept Diagnost Radiol & Nucl Med, Sch Med, Baltimore, MD USA

[31] Washington Univ St, Mallinckrodt Inst Radiol, Louis Sch Med, Div Nucl Med, 510 South Kingshighway Blvd, Campus Box 8223, St Louis, MO 63110 USA

来源：

JACC-CARDIOVASCULAR IMAGING | 2023年 / 16卷 / 04期

基金：

美国国家卫生研究院;

关键词：

coronary artery disease; coronary circulation; coronary flow reserve; microvascular dysfunction; myocardial blood flow; myocardial perfusion imaging; positron emission tomography; ARTERY-DISEASE; FLOW RESERVE; MICROCIRCULATORY RESISTANCE; BLOOD-FLOW; CLINICAL-OUTCOMES; ANGINA; IMPACT; THERMODILUTION; VASOMOTION; VELOCITY;

D O I：

10.1016/j.jcmg.2022.12.015

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Angina pectoris and dyspnea in patients with normal or nonobstructive coronary vessels remains a diagnostic challenge. Invasive coronary angiography may identify up to 60% of patients with nonobstructive coronary artery disease (CAD), of whom nearly two-thirds may, in fact, have coronary microvascular dysfunction (CMD) that may account for their symptoms. Positron emission tomography (PET) determined absolute quantitative myocardial blood flow (MBF) at rest and during hyperemic vasodilation with subsequent derivation of myocardial flow reserve (MFR) affords the noninvasive detection and delineation of CMD. Individualized or intensified medical therapies with nitrates, calcium-channel blockers, statins, angiotensin-converting enzyme inhibitors, angiotensin II type 1-receptor blockers, beta-blockers, ivabradine, or ranolazine may improve symptoms, quality of life, and outcome in these patients. Standardized diagnosis and reporting criteria for ischemic symptoms caused by CMD are critical for optimized and individualized treatment decisions in such patients. In this respect, it was proposed by the cardiovascular council leadership of the Society of Nuclear Medicine and Molecular Imaging to convene thoughtful leaders from around the world to serve as an independent expert panel to develop standardized diagnosis, nomenclature and nosology, and cardiac PET reporting criteria for CMD. This consensus document aims to provide an overview of the pathophysiology and clinical evidence of CMD, its invasive and noninvasive assessment, standardization of PET-determined MBFs and MFR into "classical" (predominantly related to hyperemic MBFs) and "endogen" (predominantly related to resting MBF) normal coronary microvascular function or CMD that may be critical for diagnosis of microvascular angina, subsequent patient care, and outcome of clinical CMD trials. (J Am Coll Cardiol Img 2023;16:536-548) (c) 2023 by the American College of Cardiology Foundation.

引用

页码：536 / 548

页数：13

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