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Journal of Nuclear Medicine Vol. 46 No. 9 1438-1443
© 2005 by Society of Nuclear Medicine

Clinical Investigations

Influence of Risk Factors on Coronary Flow Reserve in Patients with 1-Vessel Coronary Artery Disease

Maria Lucia Eufrasia Vicario, MD1, Lorenzo Cirillo, MD1, Giovanni Storto, MD2,3, Teresa Pellegrino, MD2,3, Nicola Ragone, MD1, Luca Fontanella, MD1, Mario Petretta, MD1, Domenico Bonaduce, MD1 and Alberto Cuocolo, MD2,3

1 Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University Federico II, Napoli, Italy
2 Department of Biomorphological and Functional Sciences, University Federico II, Napoli, Italy
3 Institute of Biostructure and Bioimages, National Council of Research, Napoli, Italy

Coronary artery disease (CAD) risk factors influence the hyperemic response in patients without coronary artery stenosis. The aim of this study was to evaluate the influence of risk factors on coronary flow reserve (CFR) estimated by 99mTc-sestamibi cardiac imaging in patients with 1-vessel CAD. Methods: Forty-eight patients with 1-vessel CAD were enrolled in the study. Systemic hypertension, hypercholesterolemia, diabetes mellitus, and cigarette smoking were considered CAD risk factors. Within 48 h, all patients underwent coronary angiography and regional CFR assessment by 99mTc-sestamibi imaging with dipyridamole (0.74 mg/kg of body weight). Eight patients had no risk factors, 14 had 1 risk factor, 18 had 2 risk factors, and 8 had 3 risk factors. Results: The mean ± SD CFR of the narrowed coronary vessel was 1.28 ± 0.43 in the overall study population (1.52 ± 0.30 in patients with 50%–70% stenosis and 0.94 ± 0.75 in patients with >70% stenosis; P < 0.001). Two-factor ANOVA showed that the number of risk factors significantly affected CFR (P < 0.001) in patients with 50%–70% stenosis, whereas significance was only borderline in patients with >70% stenosis. Finally, a significant interaction among the degree of coronary artery stenosis, the number of risk factors, and the estimated CFR was found (F3 = 14.0; P < 0.001). Conclusion: CFR is inversely related to the number of conventional risk factors in patients with 1-vessel CAD and intermediate coronary artery stenosis, whereas this influence is less evident in patients with more severe stenosis.

Key Words: coronary artery disease risk factors • coronary flow reserve • radionuclide cardiac imaging


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