Sub-endocardial and sub-epicardial measurement of myocardial blood flow using 13NH3 PET in man
This study examined whether measuring myocardial blood flow (MBF) in the sub-endocardial (SEN) and sub-epicardial (SEP) layers of the left ventricular myocardium using 13NH3 positron emission tomography (PET) and an automated procedure gives reasonable results in patients with known or suspected cor...
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| Veröffentlicht in: | Journal of nuclear cardiology 2020-10, Vol.27 (5), p.1665-1674 |
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| creator | Sciagrà, Roberto Milan, Elisa Giubbini, Raffaele Kubik, Tomasz Di Dato, Rossella Gallo, Lara Camoni, Luca Allocca, Michela Calabretta, Raffaella |
| description | This study examined whether measuring myocardial blood flow (MBF) in the sub-endocardial (SEN) and sub-epicardial (SEP) layers of the left ventricular myocardium using 13NH3 positron emission tomography (PET) and an automated procedure gives reasonable results in patients with known or suspected coronary artery disease (CAD).
Resting and stress 13NH3 dynamic PET were performed in 70 patients. Using ≥ 70% diameter stenosis in invasive coronary angiography (ICA) to identify significant CAD, we examined the diagnostic value of SEN- and SEP-MBF, and coronary flow reserve (CFR) vs. the corresponding conventional data averaged on the whole wall thickness.
ICA demonstrated 36 patients with significant CAD. Their global stress average [1.61 (1.26, 1.87) mL·min−1·g−1], SEN [1.39 (1.2, 1.59) mL·min−1·g−1] and SEP [1.22 (0.96, 1.44) mL·min−1·g−1] MBF were significantly lower than in the 34 no-CAD patients: 2.05 (1.76, 2.52), 1.72 (1.53, 1.89) and 1.46 (1.23, 1.89) mL·min−1·g−1, respectively, all P < .005. In the 60 CAD vs. the 150 non-CAD territories, stress average MBF was 1.52 (1.10, 1.83) vs. 2.06 (1.69, 2.48) mL·min−1·g−1, SEN-MBF 1.33 (1.02, 1.58) vs. 1.66 (1.35, 1.93) mL·min−1·g−1, and SEP-MBF 1.07 (0.80, 1.29) vs. 1.40 (1.12, 1.69) mL·min−1·g−1, respectively, all P < .05. Using receiver operating characteristics analysis for the presence of significant CAD, the areas under the curve (AUC) were all significant (P < .0001 vs. AUC = 0.5) and similar: stress average MBF = 0.79, SEN-MBF = 0.75, and SEP-MBF = 0.73. AUC was 0.77 for the average CFR, 0.75 for SEN, and 0.70 for SEP CFR. The stress transmural perfusion gradient (TPG) AUC (0.51) was not significant. However, stress TPG was significantly lower in segments subtended by totally occluded arteries vs. those subtended by sub-total stenoses: 1.10 (0.86, 1.33) vs. 1.24 (0.98, 1.56), respectively, P < .005.
Automatic assessment of SEN- and SEP-MBF (and CFR) using 13NH3 PET gives reasonable results that are in good agreement with the conventional average whole wall thickness data. Further studies are needed to examine the utility of layer measurements such as in patients with hibernating myocardium or microvascular disease. |
| doi_str_mv | 10.1007/s12350-018-1445-y |
| format | Article |
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Resting and stress 13NH3 dynamic PET were performed in 70 patients. Using ≥ 70% diameter stenosis in invasive coronary angiography (ICA) to identify significant CAD, we examined the diagnostic value of SEN- and SEP-MBF, and coronary flow reserve (CFR) vs. the corresponding conventional data averaged on the whole wall thickness.
ICA demonstrated 36 patients with significant CAD. Their global stress average [1.61 (1.26, 1.87) mL·min−1·g−1], SEN [1.39 (1.2, 1.59) mL·min−1·g−1] and SEP [1.22 (0.96, 1.44) mL·min−1·g−1] MBF were significantly lower than in the 34 no-CAD patients: 2.05 (1.76, 2.52), 1.72 (1.53, 1.89) and 1.46 (1.23, 1.89) mL·min−1·g−1, respectively, all P < .005. In the 60 CAD vs. the 150 non-CAD territories, stress average MBF was 1.52 (1.10, 1.83) vs. 2.06 (1.69, 2.48) mL·min−1·g−1, SEN-MBF 1.33 (1.02, 1.58) vs. 1.66 (1.35, 1.93) mL·min−1·g−1, and SEP-MBF 1.07 (0.80, 1.29) vs. 1.40 (1.12, 1.69) mL·min−1·g−1, respectively, all P < .05. Using receiver operating characteristics analysis for the presence of significant CAD, the areas under the curve (AUC) were all significant (P < .0001 vs. AUC = 0.5) and similar: stress average MBF = 0.79, SEN-MBF = 0.75, and SEP-MBF = 0.73. AUC was 0.77 for the average CFR, 0.75 for SEN, and 0.70 for SEP CFR. The stress transmural perfusion gradient (TPG) AUC (0.51) was not significant. However, stress TPG was significantly lower in segments subtended by totally occluded arteries vs. those subtended by sub-total stenoses: 1.10 (0.86, 1.33) vs. 1.24 (0.98, 1.56), respectively, P < .005.
Automatic assessment of SEN- and SEP-MBF (and CFR) using 13NH3 PET gives reasonable results that are in good agreement with the conventional average whole wall thickness data. Further studies are needed to examine the utility of layer measurements such as in patients with hibernating myocardium or microvascular disease.</description><identifier>ISSN: 1071-3581</identifier><identifier>EISSN: 1532-6551</identifier><identifier>DOI: 10.1007/s12350-018-1445-y</identifier><language>eng</language><publisher>Cham: Elsevier Inc</publisher><subject>Cardiology ; Cardiovascular disease ; Coronary artery disease ; Imaging ; invasive coronary angiography ; Medicine ; Medicine & Public Health ; myocardial blood flow ; N-13-ammonia ; Nuclear Medicine ; Original Article ; positron emission tomography ; Radiology</subject><ispartof>Journal of nuclear cardiology, 2020-10, Vol.27 (5), p.1665-1674</ispartof><rights>2020 American Society of Nuclear Cardiology. Published by ELSEVIER INC. All rights reserved.</rights><rights>American Society of Nuclear Cardiology 2018</rights><rights>Journal of Nuclear Cardiology is a copyright of Springer, (2018). All Rights Reserved.</rights><rights>American Society of Nuclear Cardiology 2018.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c317y-81eb64b25155a5da1fc14a3363e3bc9126968bb4fe9c09df04b7888af7a43a893</citedby><cites>FETCH-LOGICAL-c317y-81eb64b25155a5da1fc14a3363e3bc9126968bb4fe9c09df04b7888af7a43a893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12350-018-1445-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12350-018-1445-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Sciagrà, Roberto</creatorcontrib><creatorcontrib>Milan, Elisa</creatorcontrib><creatorcontrib>Giubbini, Raffaele</creatorcontrib><creatorcontrib>Kubik, Tomasz</creatorcontrib><creatorcontrib>Di Dato, Rossella</creatorcontrib><creatorcontrib>Gallo, Lara</creatorcontrib><creatorcontrib>Camoni, Luca</creatorcontrib><creatorcontrib>Allocca, Michela</creatorcontrib><creatorcontrib>Calabretta, Raffaella</creatorcontrib><title>Sub-endocardial and sub-epicardial measurement of myocardial blood flow using 13NH3 PET in man</title><title>Journal of nuclear cardiology</title><addtitle>J. Nucl. Cardiol</addtitle><description>This study examined whether measuring myocardial blood flow (MBF) in the sub-endocardial (SEN) and sub-epicardial (SEP) layers of the left ventricular myocardium using 13NH3 positron emission tomography (PET) and an automated procedure gives reasonable results in patients with known or suspected coronary artery disease (CAD).
Resting and stress 13NH3 dynamic PET were performed in 70 patients. Using ≥ 70% diameter stenosis in invasive coronary angiography (ICA) to identify significant CAD, we examined the diagnostic value of SEN- and SEP-MBF, and coronary flow reserve (CFR) vs. the corresponding conventional data averaged on the whole wall thickness.
ICA demonstrated 36 patients with significant CAD. Their global stress average [1.61 (1.26, 1.87) mL·min−1·g−1], SEN [1.39 (1.2, 1.59) mL·min−1·g−1] and SEP [1.22 (0.96, 1.44) mL·min−1·g−1] MBF were significantly lower than in the 34 no-CAD patients: 2.05 (1.76, 2.52), 1.72 (1.53, 1.89) and 1.46 (1.23, 1.89) mL·min−1·g−1, respectively, all P < .005. In the 60 CAD vs. the 150 non-CAD territories, stress average MBF was 1.52 (1.10, 1.83) vs. 2.06 (1.69, 2.48) mL·min−1·g−1, SEN-MBF 1.33 (1.02, 1.58) vs. 1.66 (1.35, 1.93) mL·min−1·g−1, and SEP-MBF 1.07 (0.80, 1.29) vs. 1.40 (1.12, 1.69) mL·min−1·g−1, respectively, all P < .05. Using receiver operating characteristics analysis for the presence of significant CAD, the areas under the curve (AUC) were all significant (P < .0001 vs. AUC = 0.5) and similar: stress average MBF = 0.79, SEN-MBF = 0.75, and SEP-MBF = 0.73. AUC was 0.77 for the average CFR, 0.75 for SEN, and 0.70 for SEP CFR. The stress transmural perfusion gradient (TPG) AUC (0.51) was not significant. However, stress TPG was significantly lower in segments subtended by totally occluded arteries vs. those subtended by sub-total stenoses: 1.10 (0.86, 1.33) vs. 1.24 (0.98, 1.56), respectively, P < .005.
Automatic assessment of SEN- and SEP-MBF (and CFR) using 13NH3 PET gives reasonable results that are in good agreement with the conventional average whole wall thickness data. Further studies are needed to examine the utility of layer measurements such as in patients with hibernating myocardium or microvascular disease.</description><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Coronary artery disease</subject><subject>Imaging</subject><subject>invasive coronary angiography</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>myocardial blood flow</subject><subject>N-13-ammonia</subject><subject>Nuclear Medicine</subject><subject>Original Article</subject><subject>positron emission tomography</subject><subject>Radiology</subject><issn>1071-3581</issn><issn>1532-6551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU1LHTEUhgepUKv-gO4C3XSTmpOPSUJXRWwVpBVqt4ZMJiORmeQ2uaPMvzeXqRZc3GxOODzP4XDepvkI5AsQIs8KUCYIJqAwcC7wctAcgWAUt0LAu_onEjATCt43H0p5IIRopvVRc_d77rCPfXI298GOyMYelV1vE15ak7dlzn7ycYvSgKblFe7GlHo0jOkJzSXEewTs5yVDNxe3KEQ02XjSHA52LP70Xz1u_ny_uD2_xNe_flydf7vGjoFcsALftbyjAoSworcwOOCWsZZ51jkNtNWt6jo-eO2I7gfCO6mUsoO0nFml2XHzeZ27yenv7MvWTKE4P442-jQXQ6E-3nLVVvTTG_QhzTnW7QzlkkkttJR7KQACoKiklYKVcjmVkv1gNjlMNi8GiNnlYtZcTM3F7HIxS3Xo6pTKxnuf_0_eJ31dJV-P-BiqVFzw0fk-ZO-2pk9hj_0MEcuhwg</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Sciagrà, Roberto</creator><creator>Milan, Elisa</creator><creator>Giubbini, Raffaele</creator><creator>Kubik, Tomasz</creator><creator>Di Dato, Rossella</creator><creator>Gallo, Lara</creator><creator>Camoni, Luca</creator><creator>Allocca, Michela</creator><creator>Calabretta, Raffaella</creator><general>Elsevier Inc</general><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20201001</creationdate><title>Sub-endocardial and sub-epicardial measurement of myocardial blood flow using 13NH3 PET in man</title><author>Sciagrà, Roberto ; 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Nucl. Cardiol</stitle><date>2020-10-01</date><risdate>2020</risdate><volume>27</volume><issue>5</issue><spage>1665</spage><epage>1674</epage><pages>1665-1674</pages><issn>1071-3581</issn><eissn>1532-6551</eissn><abstract>This study examined whether measuring myocardial blood flow (MBF) in the sub-endocardial (SEN) and sub-epicardial (SEP) layers of the left ventricular myocardium using 13NH3 positron emission tomography (PET) and an automated procedure gives reasonable results in patients with known or suspected coronary artery disease (CAD).
Resting and stress 13NH3 dynamic PET were performed in 70 patients. Using ≥ 70% diameter stenosis in invasive coronary angiography (ICA) to identify significant CAD, we examined the diagnostic value of SEN- and SEP-MBF, and coronary flow reserve (CFR) vs. the corresponding conventional data averaged on the whole wall thickness.
ICA demonstrated 36 patients with significant CAD. Their global stress average [1.61 (1.26, 1.87) mL·min−1·g−1], SEN [1.39 (1.2, 1.59) mL·min−1·g−1] and SEP [1.22 (0.96, 1.44) mL·min−1·g−1] MBF were significantly lower than in the 34 no-CAD patients: 2.05 (1.76, 2.52), 1.72 (1.53, 1.89) and 1.46 (1.23, 1.89) mL·min−1·g−1, respectively, all P < .005. In the 60 CAD vs. the 150 non-CAD territories, stress average MBF was 1.52 (1.10, 1.83) vs. 2.06 (1.69, 2.48) mL·min−1·g−1, SEN-MBF 1.33 (1.02, 1.58) vs. 1.66 (1.35, 1.93) mL·min−1·g−1, and SEP-MBF 1.07 (0.80, 1.29) vs. 1.40 (1.12, 1.69) mL·min−1·g−1, respectively, all P < .05. Using receiver operating characteristics analysis for the presence of significant CAD, the areas under the curve (AUC) were all significant (P < .0001 vs. AUC = 0.5) and similar: stress average MBF = 0.79, SEN-MBF = 0.75, and SEP-MBF = 0.73. AUC was 0.77 for the average CFR, 0.75 for SEN, and 0.70 for SEP CFR. The stress transmural perfusion gradient (TPG) AUC (0.51) was not significant. However, stress TPG was significantly lower in segments subtended by totally occluded arteries vs. those subtended by sub-total stenoses: 1.10 (0.86, 1.33) vs. 1.24 (0.98, 1.56), respectively, P < .005.
Automatic assessment of SEN- and SEP-MBF (and CFR) using 13NH3 PET gives reasonable results that are in good agreement with the conventional average whole wall thickness data. Further studies are needed to examine the utility of layer measurements such as in patients with hibernating myocardium or microvascular disease.</abstract><cop>Cham</cop><pub>Elsevier Inc</pub><doi>10.1007/s12350-018-1445-y</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Cardiology Cardiovascular disease Coronary artery disease Imaging invasive coronary angiography Medicine Medicine & Public Health myocardial blood flow N-13-ammonia Nuclear Medicine Original Article positron emission tomography Radiology |
| title | Sub-endocardial and sub-epicardial measurement of myocardial blood flow using 13NH3 PET in man |
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