TY - JOUR
T1 - Stress myocardial blood flow correlates with ventricular function and synchrony better than myocardial perfusion reserve
T2 - A Nitrogen-13 ammonia PET study
AU - Juárez-Orozco, Luis Eduardo
AU - Alexanderson, Erick
AU - Dierckx, Rudi A.
AU - Boersma, Hendrikus H.
AU - Hillege, Johannes L.
AU - Zeebregts, Clark J.
AU - Martínez-Aguilar, Myriam M.
AU - Jordán-Ríos, Antonio
AU - Ayala-German, Ana Gabriela
AU - Prakken, Niek
AU - Tio, Rene A.
AU - Slart, Riemer H.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background: Cardiac PET quantifies stress myocardial blood flow (MBF) and perfusion reserve (MPR), while ECG-gated datasets can measure components of ventricular function simultaneously. Stress MBF seems to outperform MPR in the detection of significant CAD. However, it is uncertain which perfusion measurement is more related to ventricular function. We hypothesized that stress MBF correlates with ventricular function better than MPR in patients studied for suspected myocardial ischemia. Methods: We studied 248 patients referred to a rest and adenosine-stress Nitrogen-13 ammonia PET. We performed a multivariate analysis using systolic function (left ventricular ejection fraction, LVEF), diastolic function (mean filling rate in diastole, MFR/3), and synchrony (Entropy) as the outcome variables, and stress MBF, MPR, and relevant covariates as the predictors. Secondarily, we repeated the analysis for the subgroup of patients with and without a previous myocardial infarction (MI). Results: 166 male and 82 female patients (mean age 63 ± 11 and 67 ± 11 year, respectively) were included. 60% of the patients presented hypertension, 57% dyslipidemia, 21% type 2 diabetes mellitus, 45% smoking, and 34.7% a previous MI. Mean stress MBF was 1.99 ± 0.75 mL/g/min, MPR = 2.55 ± 0.89, LVEF = 61.6 ± 15%, MFR/3 = 1.12 ± 0.38 EDV/s, and Entropy = 45.6 ± 11.3%. There was a significant correlation between stress MBF (P <.001) and ventricular function. This was stronger than the one for MPR (P =.063). Sex, age, diabetes, and extent of previous MI were also significant predictors. Results were similar for the analyses of the 2 subgroups. Conclusion: Stress MBF is better correlated with ventricular function than MPR, as evaluated by Nitrogen-13 ammonia PET, independently from other relevant cardiovascular risk factors and clinical covariates. This relationship between coronary vasodilatory capacity and ventricular function is sustained across groups with and without a previous MI.
AB - Background: Cardiac PET quantifies stress myocardial blood flow (MBF) and perfusion reserve (MPR), while ECG-gated datasets can measure components of ventricular function simultaneously. Stress MBF seems to outperform MPR in the detection of significant CAD. However, it is uncertain which perfusion measurement is more related to ventricular function. We hypothesized that stress MBF correlates with ventricular function better than MPR in patients studied for suspected myocardial ischemia. Methods: We studied 248 patients referred to a rest and adenosine-stress Nitrogen-13 ammonia PET. We performed a multivariate analysis using systolic function (left ventricular ejection fraction, LVEF), diastolic function (mean filling rate in diastole, MFR/3), and synchrony (Entropy) as the outcome variables, and stress MBF, MPR, and relevant covariates as the predictors. Secondarily, we repeated the analysis for the subgroup of patients with and without a previous myocardial infarction (MI). Results: 166 male and 82 female patients (mean age 63 ± 11 and 67 ± 11 year, respectively) were included. 60% of the patients presented hypertension, 57% dyslipidemia, 21% type 2 diabetes mellitus, 45% smoking, and 34.7% a previous MI. Mean stress MBF was 1.99 ± 0.75 mL/g/min, MPR = 2.55 ± 0.89, LVEF = 61.6 ± 15%, MFR/3 = 1.12 ± 0.38 EDV/s, and Entropy = 45.6 ± 11.3%. There was a significant correlation between stress MBF (P <.001) and ventricular function. This was stronger than the one for MPR (P =.063). Sex, age, diabetes, and extent of previous MI were also significant predictors. Results were similar for the analyses of the 2 subgroups. Conclusion: Stress MBF is better correlated with ventricular function than MPR, as evaluated by Nitrogen-13 ammonia PET, independently from other relevant cardiovascular risk factors and clinical covariates. This relationship between coronary vasodilatory capacity and ventricular function is sustained across groups with and without a previous MI.
KW - coronary artery disease
KW - myocardial perfusion reserve
KW - PET
KW - stress myocardial blood flow
KW - ventricular function
UR - http://www.scopus.com/inward/record.url?scp=84988952723&partnerID=8YFLogxK
U2 - 10.1007/s12350-016-0669-y
DO - 10.1007/s12350-016-0669-y
M3 - Article
C2 - 27681955
AN - SCOPUS:84988952723
SN - 1071-3581
VL - 25
SP - 797
EP - 806
JO - Journal of nuclear cardiology
JF - Journal of nuclear cardiology
IS - 3
ER -
