Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction

Abstract

Objective To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). Materials and Methods Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. Results The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT ( r = −0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT ( r = −0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission ( r = 0.469, p = 0.016) and at 6 months ( r = 0.585, p = 0.001). Conclusion MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.

Relationships between indicators of prothrombotic activity and coronary microvascular dysfunction in patients with myocardial infarction with obstructive and non-obstructive coronary artery disease

“…This suggests less myocardial injury in patients with MINOCA compared to patients with MI-CAD, whereas the indicators of myocardial blood flow (MBF stress, MBF rest) were lower in MI-CAD patients. Thus, the larger the area of myocardial injury, the greater the decrease in MBF and MFR [28], as demonstrated by our team previously [29].…”

Dynamic CT Myocardial Perfusion Imaging in Patients without Obstructive Coronary Artery Disease: Quantification of Myocardial Blood Flow according to Varied Heart Rate Increments after Stress

“…https://doi.org/10.3348/kjr.2020.0249 kjronline.org 4). With the recent introduction of third generation dual source CT (DSCT), it is now technically feasible to perform dynamic CT-MPI at lower radiation doses compared to previous CT scanners (5)(6)(7)(8).…”

Myocardial perfusion imaging using computed tomography: Current status, clinical value and prognostic implications

“…Nakauchi et al quantified MBF parameters using dynamic CTP with deconvolution analysis in patients after AMI and measured significant differences in tissue blood flow and blood volume between infarcted and non-infarcted myocardial territories (mean MBF: 51.96 versus 108.84 mL/ 100 g/min, P < 0.01) [64]. In patients with ST-segment elevation myocardial infarction and successful revascularization Pan et al found that MBF derived from dynamic CTP significantly and inversely correlated with peak Troponin T levels (r 5 À0.682, P < 0.001) and left ventricular function at 6 months (r 5 0.585, P 5 0.001) [65].…”