Abstract:
BACKGROUND:Myocardial ischaemia occurs principally in the subendocardial layer, whereas conventional myocardial perfusion imaging provides no information on the transmural myocardial blood flow (MBF) distribution. Subendocardial perfusion measurements and quantification of the transmural perfusion gradient (TPG) could be more sensitive and specific for the detection of coronary artery disease (CAD). The current study aimed to determine the impact of lesion severity as assessed by the fractional flow reserve (FFR) on subendocardial perfusion and the TPG using [(15)O]H2O positron emission tomography (PET) imaging in patients evaluated for CAD. METHODS AND RESULTS:Sixty-six patients with anginal chest pain were prospectively enrolled and underwent [(15)O]H2O myocardial perfusion PET imaging. Subsequently, invasive coronary angiography was performed and FFR obtained in all coronary arteries irrespective of the PET imaging results. Thirty (45%) patients were diagnosed with significant CAD (i.e. FFR ≤0.80), whereas on a per vessel analysis (n = 198), 53 (27%) displayed a positive FFR. Transmural hyperaemic MBF decreased significantly from 3.09 ± 1.16 to 1.67 ± 0.57 mL min(-1) g(-1) (P < 0.001) in non-ischaemic and ischaemic myocardium, respectively. The TPG decreased during hyperaemia when compared with baseline (1.20 ± 0.14 vs. 0.94 ± 0.17, P < 0.001), and was lower in arteries with a positive FFR (0.97 ± 0.16 vs. 0.88 ± 0.18, P < 0.01). A TPG threshold of 0.94 yielded an accuracy to detect CAD of 59%, which was inferior to transmural MBF with an optimal cutoff of 2.20 mL min(-1) g(-1) and an accuracy of 85% (P < 0.001). Diagnostic accuracy of subendocardial perfusion measurements was comparable with transmural MBF (83 vs. 85%, respectively, P = NS). CONCLUSION:Cardiac [(15)O]H2O PET imaging is able to distinguish subendocardial from subepicardial perfusion in the myocardium of normal dimensions. Hyperaemic TPG is significantly lower in ischaemic myocardium. This technique can potentially be employed to study subendocardial perfusion impairment in more detail. However, the diagnostic accuracy of subendocardial hyperaemic perfusion and TPG appears to be limited compared with quantitative transmural MBF, warranting further study.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Danad I,Raijmakers PG,Harms HJ,Heymans MW,van Royen N,Lubberink M,Boellaard R,van Rossum AC,Lammertsma AA,Knaapen Pdoi
10.1093/eurheartj/ehu170subject
Has Abstractpub_date
2014-08-14 00:00:00pages
2094-105issue
31eissn
0195-668Xissn
1522-9645pii
ehu170journal_volume
35pub_type
杂志文章abstract:AIMS:Supernatants of serum-free cultured mononuclear cells (MNC) contain a mix of immunomodulating factors (secretome), which have been shown to attenuate detrimental inflammatory responses following myocardial ischaemia. Inflammatory dilated cardiomyopathy (iDCM) is a common cause of heart failure in young patients. E...
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journal_title:European heart journal
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doi:10.1093/oxfordjournals.eurheartj.a062359
更新日期:1987-08-01 00:00:00
abstract:AIMS:It is reported that one third of patients with heart failure have normal left ventricular systolic function, and may or may not have left ventricular diastolic dysfunction. We sought to define the prevalence of left ventricular diastolic filling abnormalities in a large unselected group of patients, unlike the dia...
journal_title:European heart journal
pub_type: 临床试验,杂志文章
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更新日期:1997-06-01 00:00:00
abstract::Intracoronary blood flow velocity measurements with a Doppler balloon catheter and the radiographic assessment of myocardial perfusion with contrast media, before and after the intracoronary administration of papaverine, have previously been used to investigate regional coronary flow reserve. In the present study we a...
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doi:10.1093/oxfordjournals.eurheartj.a059557
更新日期:1989-08-01 00:00:00
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更新日期:2014-02-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_n.176
更新日期:1988-12-01 00:00:00
abstract::The effects of oral sotalol were compared with the findings obtained in the baseline study of a group of 26 consecutive patients with sustained monomorphic ventricular tachycardia or ventricular fibrillation and inducible ventricular tachycardia. The mean age was 62 years and the mean ejection fraction 33%. The number...
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059469
更新日期:1989-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060109
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doi:10.1093/eurheartj/16.suppl_o.133
更新日期:1995-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2014-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060504
更新日期:1994-03-01 00:00:00
abstract::Congestive heart failure is the most common cause of death in young adults with thalassaemia major. In the present study we compared atrial natriuretic peptide levels (ANP) in 30 asymptomatic patients with thalassaemia major (aged 16.6 +/- 6.4 years), normal left ventricular diastolic cavity dimension and systolic fun...
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060068
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doi:10.1093/eurheartj/12.suppl_d.171
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doi:10.1093/eurheartj/14.1.40
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更新日期:2014-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:1992-09-01 00:00:00
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更新日期:1997-12-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1997.0730
更新日期:1998-01-01 00:00:00
abstract::A series of 42 patients with chest pain but normal coronary angiograms and normal haemodynamics at rest were prospectively classified as typical angina (group 1, N = 9) or atypical angina (group 2, N = 16) or non-anginal chest pain (group 3, N = 17). All patients underwent radionuclide ventriculography and measurement...
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062119
更新日期:1986-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059450
更新日期:1989-02-01 00:00:00
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更新日期:2004-09-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1992-12-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1990-11-01 00:00:00