OtherClinical Investigations

PET-Measured Responses of MBF to Cold Pressor Testing Correlate with Indices of Coronary Vasomotion on Quantitative Coronary Angiography

Thomas H. Schindler, Egbert U. Nitzsche, Manfred Olschewski, Ingo Brink, Michael Mix, John Prior, Alvaro Facta, Massayuki Inubushi, Hanjoerg Just and Heinrich R. Schelbert
Journal of Nuclear Medicine March 2004, 45 (3) 419-428;

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Study protocol. (A) Study inclusion at coronary angiography and quantitative assessment of epicardial vasoreactivity during CPT. a = angiogram. (B) Within 20 d of study inclusion MBF assessment with PET at rest and during CPT.

  • FIGURE 2.
    FIGURE 2.

    (A) Normal coronary angiogram of the left coronary tree in the RAO view of a control patient. (B) Corresponding coronary angiogram during sympathetic activation by CPT. (C and D) Quantitative coronary angiographic evaluation of the proximal-mid LAD segment at rest (mean diameter, 2.0 mm) (C) and during CPT (mean diameter, 2.5 mm) (D).

  • FIGURE 3.
    FIGURE 3.

    (A) Normal coronary angiogram of the left coronary artery tree in the LAO view in a chronic smoker at baseline. (B) Corresponding coronary angiogram during sympathetic activation by CPT. (C and D) Quantitative coronary angiographic evaluation of the proximal-mid LAD segment at rest (mean diameter, 1.89 mm) (C) and during CPT (mean diameter, 1.57 mm) (D).

  • FIGURE 4.
    FIGURE 4.

    Correlation of CPT-induced change in RPP and epicardial LA in normal control patients (○) and in the group at risk for CAD (•), demonstrating a significant correlation in normal patients but no relation for patients at risk for CAD.

  • FIGURE 5.
    FIGURE 5.

    Correlation of CPT-induced change in RPP and regional MBF in normal control patients (○) and in the group at risk for CAD (•), revealing a significant correlation in normal patients but no relation for patients at risk for CAD.

  • FIGURE 6.
    FIGURE 6.

    Percent change of CVR in the control group and in patients at risk for CAD.

  • FIGURE 7.
    FIGURE 7.

    Percent change of epicardial LA and MBF to CPT of the study population.

Tables

  • TABLE 1

    Characteristics of Study Population

    CharacteristicControl group (n = 22)At-risk group (n = 34)
    Age (y)57 ± 656 ± 6
    Sex (F/M)14/819/15
    Hypertension016
    Hypercholesterolemia010
    Smoking08
    Lipid status
     Serum cholesterol level (mg/dL)186 ± 50218 ± 40*
     Serum LDL level (mg/dL)114 ± 40144 ± 24*
     Serum HDL level (mg/dL)53 ± 1247 ± 12
     Triglyceride level125 ± 38140 ± 52
     Glucose level (mg/dL)88 ± 795 ± 15
    Epicardial LA (mm2)
     Before CPT5.01 ± 1.075.13 ± 1.49
     After CPT5.88 ± 0.894.24 ± 1.12
     % Change19 ± 9−16 ± 12*
    MBF (mL · g−1 · min−1)
     Before CPT0.77 ± 0.160.76 ± 0.20
     After CPT1.34 ± 0.340.83 ± 0.25
     % Change74 ± 2311 ± 19*
    Coronary vascular resistance (mm Hg/mL · g−1 · min−1)
     Before CPT114 ± 23122 ± 27
     After CPT80 ± 14128 ± 32
     % Change−43 ± 136 ± 17*

    • ↵* P < 0.001 vs. normal controls.

    • LDL = low-density lipoprotein; HDL = high-density lipoprotein.

    • Values are mean ± SD.

  • TABLE 2

    Hemodynamics in QCA and PET Studies at Rest and During CPT

    TestQCAPET
    RestCPTRestCPT
    HR (bpm)62 ± 867 ± 7*60 ± 966 ± 10†
    SBP (mm Hg)108 ± 13136 ± 17*111 ± 11139 ± 17†
    DBP (mm Hg)75 ± 1281 ± 9*73 ± 881 ± 8†
    RPP6,674 ± 9959,146 ± 1,431*6,636 ± 1,2219,199 ± 1,634†
    %ΔRPP37 ± 17*40 ± 21†
    MAP (mm Hg)87 ± 6100 ± 7*86 ± 5101 ± 7†

    • ↵* P ≤ 0.0001, CPT vs. rest for each corresponding hemodynamic parameter in QCA study evaluation.

    • ↵† P ≤ 0.0001, CPT vs. rest for each corresponding hemodynamic parameter in PET study evaluation.

    • HR = heart rate; SBP = systolic blood pressure; DBP = diastolic blood pressure; RPP = systolic blood pressure × heart rate; %ΔRPP = percent change of RPP from rest during CPT; MAP = mean arterial blood pressure.

    • Values are mean ± SD.

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