Myocardial flow reserve derived by dynamic perfusion single-photon emission computed tomography reflects the severity of coronary atherosclerosis

Abstract

A novel single-photon emission computed tomography (SPECT) camera was developed to evaluate dynamic myocardial perfusion flow. However, it is unclear whether myocardial flow reserve (MFR) derived by dynamic perfusion SPECT using the novel SPECT camera (D-SPECT) reflects the severity of coronary atherosclerosis. In the present study, we therefore examined the relationship between MFR using D-SPECT and severity of coronary lesions. The study population comprised 40 patients who underwent both a myocardial dynamic perfusion SPECT study and invasive coronary angiography. The severity of coronary atherosclerosis was evaluated using the Gensini score. All patients underwent a rest/stress SPECT imaging protocol using Tc-99m-sestamibi, and dynamic acquisition was performed. Stress and rest flow was evaluated, and the global and regional MFR was calculated. Global MFR showed a significant negative correlation with Gensini score (r = - 0.345, p = 0.037). Multiple linear regression analysis showed that only global MFR was independently related to Gensini score (p = 0.018). Regional MFR was significantly lower in regions with 90% ≤ stenotic lesions compared with regions with < 90% stenotic lesions (p = 0.009). Global MFR derived by dynamic perfusion SPECT using D-SPECT reflects the severity of coronary atherosclerosis. Further, regional MFR is modulated by severe coronary artery stenotic lesions.

Evaluation of myocardial blood flow and coronary flow reserve — the physiological foundation and clinical significance of myocardial perfusion scintigraphy in the examination of patients with chronic coronary syndrome

“…Недавно была представлена схожая по дизайну работа [38], в которой на основании обследования 41 больного с ишемической болезнью сердца (ИБС) у пациентов с нарушенной миокардиальной перфузией было выявлено значимое снижение глобальных значений МК на нагрузке (1,14 (0,83-1,61) [41] также было выявлено, что РКК отрицательно коррелировал (r=-0,345, p=0,037) с интегральным индексом тяжести коронарного атеросклероза (индексом Gensini). Кроме того, регионарный РКК был значимо (p=0,009) снижен в бассейне коронарных артерий, имеющих сужение ≥90%.…”

Cardiovascular imaging 2018 in the International Journal of Cardiovascular Imaging

“…It is unclear whether myocardial flow reserve (MFR) derived by dynamic perfusion SPECT using a novel D-SPECT camera reflects the severity of coronary atherosclerosis. Iguchi et al [30] studied 40 patients who underwent both a myocardial dynamic perfusion SPECT study and invasive coronary angiography. All patients underwent a rest/ stress SPECT imaging protocol using Tc-99m-sestamibi and dynamic acquisition was performed.…”

Status of Nuclear Cardiology Progress in Japan 2020

“…Myocardial perfusion reserve has so far been assessed in Japan only by positron emission computed tomography (PET) with 13 N-ammonia and 15 O-water. However, the number of cardiac PET studies has been lower than expected in Japan except for 18 F-fluorodeoxy glucose (FDG) in cardiac sarcoidosis.…”