Estimation of coronary flow reserve by sestamibi imaging in patients with mild hypertension and normal coronary arteries(495 views) Storto G, Gallicchio R, Maddalena F, Pellegrino T, Petretta M, Fiumara G, Cuocolo A
Q J Nucl Med Mol Im (ISSN: 1824-4785, 1824-4478, 1827-1936), 2014 Mar 14; 59(3): 336-341.
IRCCS, CROB, Rionero in Vulture, Potenza, Italy - cuocolo@unina.it.
Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
Department of Translational Medical Sciences, University Federico II, Naples, Italy
SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
Department of Advanced Biomedical Sciences, University Federico II, via S. Pansini 5, Naples, 80131, Italy
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Estimation of coronary flow reserve by sestamibi imaging in patients with mild hypertension and normal coronary arteries
AIM:Patients with hypertension may exhibit abnormal vasodilator capacity during pharmacological vasodilatation. We assessed coronary flow reserve (CFR) by sestamibi imaging in hypertensive patients with normal coronary vessels. METHODS: Twenty-five patients with untreated mild essential hypertension and normal coronary vessels and 10 control subjects 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 tomograhic images. CFR was expressed as the ratio of stress to rest MBF. Coronary vascular resistances (CVR) were computed as the ratio between mean arterial pressure and MBF. RESULTS: Estimated MBF at rest was not different in patients and controls (1.11+/-0.59 vs. 1.14+/-0.28 counts/pixel/s; P=0.87). Conversely, stress MBF was lower in patients than in controls (1.55+/-0.47 vs. 2.68+/-0.53 counts/pixel/s; P<0.001). Thus, CFR was reduced in patients compared to controls (1.61+/-0.58 vs. 2.43+/-0.62; P<0.001). Rest and stress CVR values were higher in patients (P<0.001), while stress-induced changes in CVR were not different (P=0.08) between patients (-51%) and controls (-62%). In the overall study population, a significant relation between CFR and stress-induced changes in CVR was observed (r=-0.86; P<0.001). CONCLUSION: Sestamibi imaging may detect impaired coronary vascular function in response to dipyridamole in patients with untreated mild essential hypertension and normal coronary arteries. A mild increase in arterial blood pressure does not affect baseline MBF, but impairs coronary reserve due to the amplified resting coronary resistances.
Estimation of coronary flow reserve by sestamibi imaging in patients with mild hypertension and normal coronary arteries
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