Download fulltext HTML
Bockeria, L. A., Aslanidis, I. P., Shavman, M. G., Shurupova, I. V., Trifonova, T. A., Ekaeva, I. V., & Kotlyarov, A. A. (2018). Detection of Functional Significance of Coronary Stenoses Using Dynamic 13N-Ammonia Stress-PET/CT with Absolute Values of Myocardial Blood Flow and Coronary Flow Reserve. KnE Energy, 3(2), 52–57. https://doi.org/10.18502/ken.v3i2.1791

https://doi.org/10.18502/ken.v3i2.1791

statistics

  • 429 Abstract Views
  • 247 PDF Views
  • 0 HTML Views

authors

  • L A Bockeria
    No author data available.
  • I P Aslanidis
    No author data available.
  • M G Shavman
    No author data available.
  • I V Shurupova
    No author data available.
  • T A Trifonova
    No author data available.
  • I V Ekaeva
    No author data available.
  • A A Kotlyarov
    No author data available.

Published Date

  • Apr 17, 2018

Detection of Functional Significance of Coronary Stenoses Using Dynamic 13N-Ammonia Stress-PET/CT with Absolute Values of Myocardial Blood Flow and Coronary Flow Reserve

KnE Energy / The 2nd International Symposium "Physics, Engineering and Technologies for Biomedicine" / Pages 52–57

Abstract

Objectives. The aim of the study was to compare the values of myocardial blood flow (MBF) at stress, MBF at rest and coronary flow reserve (CFR) obtained by 13Nammonia stress-PET/CT in patients with various degrees of coronary stenosis and in healthy patients. And thus to estimate the possible contribution of the stress-PET/CT quantitative data to the detection of functionally significant coronary stenoses in patients with coronary artery disease (CAD). Materials and methods. 63 patients (mean age 64±9 years) with known CAD underwent dynamic 13N-ammonia stress-PET/CT followed by calculation of MBF both at stress and at rest in absolute units and CFR. We compared quantitative values in two groups of patients with coronary artery stenosis: 1) ≥75% (n = 36) and 2) <75% (n = 27) confirmed by invasive coronary angiography and in group of healthy patients (n = 11). Results. MBF at stress was significantly lower in group with ≥75% diameter stenoses (median 1,44 [1,21; 1,85] mL/min per g) compared with group with <75% diameter stenoses (2,42 [1,75; 2,89] mL/min/g) and the normal group (2,54 [2,31; 2,86] mL/min/g), (p <0,001). There was no reliable difference in MBF at rest between the three groups (p = NS). CFR was significantly lower in the group of patients with severe ≥75% stenoses (1,85 [1,54; 2,31]) in comparison with patients group with stenoses of intermediate <75% severity (2,73 [2,19; 3,21]), and also in comparison with the normal group (3,12 [2,75; 3,23]), (p <0,001). Conclusion. The values of MBF at stress and CFR are significantly lower in patients with severe coronary arteries stenoses comparing with the group of patients with mild and moderate stenoses. The value of MBF at rest used independently has no diagnostic utility for detection of functional significance of coronary artery stenoses.


Keywords: myocardial blood flow, coronary flow reserve, PET/CT, 13N-ammonia, coronary stenosis.

References
[1] Fiechter M. Ghadri J.R., Gebhard C., Fuchs T.A., Pazhenkottil A.P., Nkoulou R.N. et al. Diagnostic value of 13N-ammonia myocardial perfusion PET: added value of myocardial flow reserve. J Nucl Med. 53(8):1230-4, 2012.


[2] Juneau D., Erthal F., Ohira H., Mc Ardle B., Hessian R., deKemp R.A., Beanlands R.S. Clinical PET myocardial perfusion imaging and flow quantification. Cardiol Clin. 34(1):69-85, 2016.


[3] Beanlands R.S.B., Muzik O., Pierre M., Sutor R., Sawada S., Muller D. et al. Noninvasive quantification of regional myocardial flow reserve in patients with coronary atherosclerosis using Nitrogen-13 ammonia positron emission tomography. Determination of extent of altered vascular reactivity. J. Am. Coll. Cardiol. 26:1465-75, 1995.


[4] Nesterov S.V., Han C., Maki M., et al. Myocardial perfusion quantitation with 15Olabelled water PET: high reproducibility of the new cardiac analysis software (Carimas). Eur J Nucl Med Mol Imaging. 36:1594–602, 2009.


[5] Camici P.G., Crea F. Coronary microvascular dysfunction, The New England Journal of Medicine, N. Engl. J. Med. 356:830-40, 2007.


[6] Fiechter M., Ghadri J.R., Gebhard C., Fuchs T.A., Pazhenkotti A.P., Nkoulou R.N. et al. Diagnostic value of 13N-ammonia myocardial perfusion PET: added value of myocardial flow reserve. J. Nucl. Med. 53:1230–1234, 2012.


[7] Lee J.M., Kim C.H., Koo B.K., Hwang D., Park J., Zhang J. et al. Integrated myocardial perfusion imaging diagnostics improve detection of functionally signifiant coronary artery stenosis by 13N-ammonia positron emission tomography. Circ Cardiovasc Imaging. 9:e004768, 2016.