Structural Abnormalities of the Coronary Arterial Wall-in Addition to Luminal Narrowing-Affect Myocardial Blood Flow Reserve

被引：47

作者：

Liga, Riccardo ^{[2
]}

Marini, Cecilia ^{[3
]}

Coceani, Michele ^{[1
]}

Filidei, Elena ^{[1
]}

Schlueter, Mathis ^{[1
]}

Bianchi, Massimiliano ^{[4
]}

Rossi, Giuseppe ^{[1
,4
]}

Pardini, Silvia ^{[4
]}

Salvadori, Piero ^{[4
]}

Parodi, Oberdan ^{[4
]}

Rovai, Daniele ^{[1
,4
]}

Sambuceti, Gianmario ^{[5
]}

Marraccini, Paolo ^{[1
,4
]}

Neglia, Danilo ^{[1
,4
]}

机构：

[1] Fdn Toscana G Monasterio, I-56124 Pisa, Italy

[2] Scuola Super Sant Anna, Pisa, Italy

[3] CNR, Inst Bioimages & Mol Physiol, Sect Genova, I-56124 Pisa, Italy

[4] CNR, Inst Clin Physiol, I-56124 Pisa, Italy

[5] Univ Genoa, Genoa, Italy

来源：

JOURNAL OF NUCLEAR MEDICINE | 2011年 / 52卷 / 11期

关键词：

myocardial blood flow reserve; coronary wall structure; coronary calcium; multislice computed tomography; positron emission tomography; EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY; AMERICAN-HEART-ASSOCIATION; COMPUTED-TOMOGRAPHY; VASODILATOR RESERVE; MICROVASCULAR DYSFUNCTION; QUANTITATIVE RELATIONSHIP; PERFUSION ABNORMALITIES; CLINICAL CARDIOLOGY; STENOSIS SEVERITY; PROGNOSTIC VALUE;

D O I：

10.2967/jnumed.111.091009

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Multislice CT provides information on coronary luminal narrowing and on the structural abnormalities of the coronary arterial wall using densitometric analysis. We sought to investigate the effects of coronary luminal narrowing, structural abnormalities of the coronary arterial wall, and cardiovascular risk factors on regional and global myocardial blood flow (MBF) reserve. Methods: We studied 68 patients (mean age +/- SD, 61 +/- 10 y; 41 men, 27 women) with an intermediate probability of coronary artery disease. We measured the severity of coronary stenoses and the fibroadipose, fibromuscular, and calcium components of the coronary arterial wall by 64-row multislice CT coronary angiography. We also measured regional and global MBF reserve by PET using N-13-ammonia as a flow tracer at rest and after dipyridamole. Results: One or more significant coronary stenoses (>= 50% luminal narrowing) was present in 32 patients (47%), and nonsignificant stenoses were present in 15 patients (22%). Regional MBF reserve was significantly different in the territories perfused by normal coronary arteries, nonsignificant coronary stenoses, and significant coronary stenoses (P < 0.001). Calcium content was higher in the coronary arteries with significant or nonsignificant stenoses (0.95% +/- 1.08% and 0.73% +/- 0.93%, respectively) than in those without stenoses (0.11% +/- 0.38%, P < 0.001). Significant coronary stenosis (P = 0.047) and calcium content (P = 0.017) were the only independent determinants of impaired regional MBF reserve using multi-variate analysis. At multiple logistic regression analysis, the Framingham risk score, an index of global cardiovascular risk burden, was the only significant determinant of global MBF reserve (P = 0.028). Conclusion: Coronary stenoses and coronary calcium content independently affect regional MBF reserve. Framingham risk score is the only significant determinant of global MBF reserve.

引用

页码：1704 / 1712

页数：9

共 35 条

[1] 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis [J].