Author + information
- Kenji Fukushima,
- Yuka Matsuo,
- Mitsuru Momose,
- Michinobu Nagao,
- Nobuyuki Kihara,
- Stephan Nekolla,
- Akiko Sakai,
- Kayoko Sato,
- Nobuhisa Hagiwara and
- Shuji Sakai
Background: This study was to assess patient's vessel based coronary flow reserve (CFR) by integrating coronary CT angiography (CTA) and 13N ammonia PET (PET) and to demonstrate its incremental value.
Methods: 45 patients who underwent CTA and PET were enrolled (male 39, post PCI=13, OMI=3). 3D image registration of CTA and PET were performed and global and vessel CFR was analyzed using an Voronoi segmentation based on CTA data (figure) which was used to facilitate polar map analysis. Coronary stenosis were visually graded (normal to minimal=1, mild to moderate=2, severe or occluded=3). A visual scoring of rest/adenosine stress PET perfusion image used AHA 17 segment and scaling of 0-4. Patients with summed differential score > 2 were defined as ischemia.
Results: 28 patients had ischemia. Global CFR did not show significant difference between with or without ischemia (2.1±0.5 vs. 2.3±0.8, p=0.057). However, in vessel based analysis, vessel CFR was maintained in grade 1 and 2, but significantly reduced in 3 (2.38±0.77, 2.28±0.72, and 1.74±0.45; p=0.0003 vs. 1 & 2). In the ischemia group, patients with normal global CFR (>2.0, n=15) showed significant higher vessel CFR in remote territory compared to those of lower (<2.0) (2.03±0.51 vs. 1.36±0.31, p=0.0006).
Conclusions: A maintained global CFR but regional ischemia was the result of elevated CFR in the remote vessel territories. Thus, patient specific coronary bed CFR analysis can add incremental information regarding coronary atherosclerosis and ischemia.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Nuclear Cardiology: Coronary Flow
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1288-199
- 2017 American College of Cardiology Foundation