Low-dose dynamic myocardial perfusion imaging by CZT-SPECT in the identification of obstructive coronary artery disease(10 visite) Acampa W, Assante R, Mannarino T, Zampella E, D'Antonio A, Buongiorno P, Gaudieri V, Nappi C, Giordano A, Mainolfi CG, Petretta M, Cuocolo A
Eur J Nucl Med (ISSN: 1619-7070linking, 1619-7070print, 1619-7089electronic), 2019 Dec 17; N/D: N/D-N/D.
Tipo di articolo: Journal Article,
Impact factor: 5.036, Impact factor a 5 anni: 4.665
Url: Non disponibile.
Parole chiave: Czt Camera
, Dynamic Spect
, Myocardial Blood Flow
, Myocardial Perfusion Reserve,
*** IBB - CNR *** Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy. Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy. Department of Translational Medical Sciences, University Federico II, Naples, Italy.
BACKGROUND: We measured myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) by a dynamic low-dose CZT-SPECT protocol in patients with suspected or known coronary artery disease (CAD) and investigated the capability of dynamic data in predicting obstructive CAD. A total of 173 patients with suspected or known CAD underwent dynamic CZT-SPECT after the injection of 155 MBq and 370 MBq of (99m)Tc-sestamibi for rest and stress imaging, respectively. Standard rest and stress imaging were performed at the end of each dynamic scan. A total perfusion defect (TPD) < 5% were considered normal. Obstructive CAD was defined as >/= 70% stenosis at coronary angiography. RESULTS: Global MPR was lower (p < 0.05) in patients with abnormal compared with those with normal MPI (2.40 +/- 0.7 vs. 2.70 +/- 0.8). A weak, albeit significant correlation between TPD and MPR (r = - 0.179, p < 0.05) was found. In 91 patients with available angiographic data, hyperemic MBF (2.59 +/- 1.2 vs. 3.24 +/- 1.1 ml/min/g) and MPR (1.96 +/- 0.7 vs. 2.74 +/- 0.9) were lower (both p < 0.05) in patients with obstructive CAD (n = 21) compared with those without (n = 70). At univariable analysis, TPD, hyperemic MBF, and MPR were significant predictors of obstructive CAD, whereas only MPR was independent predictor at multivariable analysis (p < 0.05). At per vessels analysis, regional hyperemic MBF (2.59 +/- 1.2 vs. 3.24 +/- 1.1 ml/min/g) and regional MPR (1.96 +/- 0.7 vs. 2.74 +/- 0.9) were lower in the 31 vessels with obstructive CAD compared with 242 vessels without (both p < 0.05). CONCLUSIONS: In patients with suspected or known CAD, MPR assessed by low-dose dynamic CZT-SPECT showed a good correlation with myocardial perfusion imaging findings and it could be useful to predict obstructive CAD.<br>