PET-measured longitudinal flow gradient correlates with invasive fractional flow reserve in CAD patients

Valenta, Ines; Antoniou, Alexander; Marashdeh, Wael; Leucker, Thorsten M.; Kasper, Edward K.; Jones, Steven R.; Dannals, Robert F.; Solnes, Lilja B.; Pomper, Martin G.; Schindler, Thomas H.

doi:10.1093/ehjci/jew116

Cited by 21 publications

(45 citation statements)

References 37 publications

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“…For the assessment of coronary circulatory function, PETmeasurements MBFs at rest and its response various forms of vasomotor stress can be conducted (1,5,8,9). The latter may include bicycle exercise, dobutamine stress, sympathetic stimulation with cold pressor testing (CPT), vascular smooth muscle cell relaxation at the site of the coronary arteriolar vessels, or heterogenous responses of MBF in more apical and more basal regions of the left ventricle as a possible noninavsive index of epicardial vasomotion.…”

Section: Pet-determined Parameters Of Coronary Circulatory Dysfunctiomentioning

confidence: 99%

From Myocardial Blood Flow to Receptor Imaging with PET

Schindler

2019

Annals of Nuclear Cardiology

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Cardiac PET with assessment of myocardial perfusion and flow quantification with cardiovascular risk prediction in clinically-manifest and subclinical CAD has evolved as a mainstay in the clinical decision-making process. In this respect, cardiovascular PET continuous to expand its clinical scope with assessment of infiltrative-inflammatory cardiac disease, vasculitis, and device infections. Conversely, PET flow quantification for the identification and characterization of coronary circulatory dysfunction in conjunction with various biomarkers has provided unique "in vivo" insight into early functional stages of the CAD process that may complement or even guide experimental studies that investigate direct cause-effect relationships. Further, emerging radiotracer probes with PET may probe non-invasively myocardial receptor expressions, such as cannabinoid type 1 receptors that may play a role in heart failure development in obesity and/or diabetes mellitus deserving further clinical evaluation.

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Section: Pet-determined Parameters Of Coronary Circulatory Dysfunctiomentioning

confidence: 99%

From Myocardial Blood Flow to Receptor Imaging with PET

Schindler

2019

Annals of Nuclear Cardiology

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“…The diagnostic and prognostic value of flow and flow reserve measured using dynamic cardiac PET perfusion imaging is now well established (11,19,20,(23)(24)(25)(26)(27)(28)(29)(30)(31) and presents the advantage for excluding balanced ischemia due to 3-vessel CAD. (19, 20, 23-31,) ASNC guidelines note that quantification of MBF using PET appears to be most useful in the following circumstances (11): "1) patients without a known history of CAD who present with symptoms suspect for myocardial ischemia; 2) patients with known CAD, in whom more specific physiological assessment is desired; 3) Identifying [patients with] an increased suspicion for multi-vessel CAD; 4) to assess possible microvascular dysfunction; 5) heart transplant patients when there is a question of transplant vasculopathy".…”

Section: How To Differentiate Microvascular Disease From 3-vessel Dismentioning

confidence: 99%

Myocardial perfusion imaging: Lessons learned and work to be done—update

Iskandrian

Dilsizian

Garcia

et al. 2018

Journal of Nuclear Cardiology

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As the second term of our commitment to Journal begins, we, the editors, would like to reflect on a few topics that have relevance today. These include prognostication and paradigm shifts; Serial testing: How to handle data? Is the change in perfusion predictive of outcome and which one? Ischemia-guided therapy: fractional flow reserve vs perfusion vs myocardial blood flow; positron emission tomography (PET) imaging using Rubidium-82 vs N-13 ammonia vs F-18 Flurpiridaz; How to differentiate microvascular disease from 3-vessel disease by PET? The imaging scene outside the United States, what are the differences and similarities? Radiation exposure; Special issues with the new cameras? Is attenuation correction needed? Are there normal databases and are these specific to each camera system? And finally, hybrid imaging with single-photon emission tomography or PET combined with computed tomography angiography or coronary calcium score. We hope these topics are of interest to our readers.

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“…Patients with HIV on stable anti-retroviral therapy were shown to have reduced peak MBF under stress conditions with preserved CFR [27]. A study by Valenta et al demonstrated a close correlation between the longitudinal MBF and invasively measured fractional flow reserve under conditions of hyperemia for the assessment of a coronary stenosis [28]. In the future, it will be important to pursue more studies to attempt to use CFR as both a tool to assist with clinical decision-making and a marker of cardiac health and correlate improvement in CFR with a reduction in primary cardiovascular outcomes.…”

Section: Positron Emission Tomographymentioning

confidence: 99%