Purpose: We assessed coronary flow reserve (CFR) by sestamibi imaging in patients with typical chest pain, positive exercise stress test and normal coronary vessels. Methods: Thirty-five patients with typical chest pain and normal angiogram and 12 control subjects with atypical chest pain underwent dipyridamole/rest Tc-99m sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first transit counts in pulmonary artery and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of stress to rest MBF. Rest MBF and CFR were corrected for rate pressure product (RPP) and expressed as normalized MBF (MBFn) and normalized CFR (CFRn). Coronary vascular resistances (CVR) were calculated as the ratio between mean arterial pressure and estimated MBF. Results: At rest estimated MBF and MBFn were lower in controls compared to patients (0.98±0.4 vs 1.30±0.3 counts/pixel/sec and 1.14±0.5 vs 1.64±0.6 counts/pixel/sec, respectively, both p<0.02). Stress MBF was not different between controls and patients (2.34±0.8 vs 2.01±0.7 counts/pixel/sec, p=NS). Estimated CFR was 2.40±0.3 in controls and 1.54±0.3 in patients (p<0.0001). After correction for the RPP, CFRn was still higher in controls compared to patients (2.1±0.5 vs 1.29±0.5, p<0.0001). At baseline, CVR values were lower (p<0.01) in patients than controls. Dipyridamole-induced changes in CVR were greater (p<0.0001) in controls (-63%) than patients (-35%). In the overall study population, a significant correlation between dipyridamole-induced changes in CVR and CFR was observed (r=-0.88, p<0.0001). Conclusions: SPECT might represent a useful noninvasive method for assessing coronary vascular function in patients with angina and normal coronary angiogram.

Assessment of coronary flow reserve by sestamibi imaging in patients with typical chest pain and normal coronary arteries (European Journal of Nuclear Medicine and Molecular Imaging (2007) 34, (1156-1161) DOI: 10.1007/s00259-006- 0333-x)

Cuocolo A.
2007

Abstract

Purpose: We assessed coronary flow reserve (CFR) by sestamibi imaging in patients with typical chest pain, positive exercise stress test and normal coronary vessels. Methods: Thirty-five patients with typical chest pain and normal angiogram and 12 control subjects with atypical chest pain underwent dipyridamole/rest Tc-99m sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first transit counts in pulmonary artery and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of stress to rest MBF. Rest MBF and CFR were corrected for rate pressure product (RPP) and expressed as normalized MBF (MBFn) and normalized CFR (CFRn). Coronary vascular resistances (CVR) were calculated as the ratio between mean arterial pressure and estimated MBF. Results: At rest estimated MBF and MBFn were lower in controls compared to patients (0.98±0.4 vs 1.30±0.3 counts/pixel/sec and 1.14±0.5 vs 1.64±0.6 counts/pixel/sec, respectively, both p<0.02). Stress MBF was not different between controls and patients (2.34±0.8 vs 2.01±0.7 counts/pixel/sec, p=NS). Estimated CFR was 2.40±0.3 in controls and 1.54±0.3 in patients (p<0.0001). After correction for the RPP, CFRn was still higher in controls compared to patients (2.1±0.5 vs 1.29±0.5, p<0.0001). At baseline, CVR values were lower (p<0.01) in patients than controls. Dipyridamole-induced changes in CVR were greater (p<0.0001) in controls (-63%) than patients (-35%). In the overall study population, a significant correlation between dipyridamole-induced changes in CVR and CFR was observed (r=-0.88, p<0.0001). Conclusions: SPECT might represent a useful noninvasive method for assessing coronary vascular function in patients with angina and normal coronary angiogram.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11588/890429
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