Effects of coronary heart disease risk factors on ¹³N-amonia quantitative myocardial perfusionin patients with no or mild coronary stenosis

Objectives: to explore the effect of risk factors of coronary heart disease(CHD) on reduction of myocardial blood flow and coronary flow reserve in patients with no or mild coronary stenosis.

Methods: Retrospectively collected data of quantitative myocardial perfusion from ¹³N--amonia PET myocardial perfusion imaging(MPI) and overall CHD risks of 68 consecutive patients with no or mild coronary stenosis. Quantitative myocardial perfusion data concluded minimum, maximum and average value of rest myocardial blood flow(MBF), stress MBF and coronary flow reserve (CFR). CHD risks concluded patients’ age, gender, body mass index (BMI), waist hip ratio(WHR) ,diabetes, hypertension, dyslipidemia, long-term smoking, family history of cardiovascular disease and complications that may affect myocardial perfusion. The logistic regression statistical method was applied to analyze the effect of CHD risk factors on myocardial perfusion abnormalities.

Results: Age(OR=7.672, P=0.003, 95%CI: 1.977~29.766) and diabetes(OR=10.519, P=0.012, 95%CI: 1.693~65.376) are risk factors of minimum CFR. Age (OR=3.167, P=0.049, 95%CI: 1.003~10.001) is a risk factor of average CFR. Age (OR=3.600, P=0.022, 95%CI: 1.201~10.749) is a risk factor of maximum CFR. Diabetes (OR=11.207, P=0.024, 95%CI:1.368~91.803) is a risk factor of minimum stress MBF. Sex (OR=6.937, P=0.003, 95%CI: 1.925~24.994) and BMI (OR=3.582, P=0.045, 95%CI: 1.027~12.499) are risk factors of average stress MBF. WHR (OR=8.793, P=0.001, 95%CI: 2.313~33.428) and myocardial ischemia symptoms (OR=4.865, P=0.012, 95%CI: 1.423~16.630) are risk factors of maximum stress MBF. WHR (OR=5.399, P=0.003, 95%CI: 1.763~16.531) and myocardial ischemia symptoms (OR=4.101, P=0.013, 95%CI: 1349~12.471) are risk factors of minimum rest MBF. Sex (OR=34.069, P=0.001, 95%CI: 4.041~287.236) and BMI (OR=7.721, P=0.007, 95%CI: 1.766~33.747) are risk factors of mean rest MBF. Sex (OR=5.525, P=0.007, 95%CI: 1.590~19.194) and BMI (OR=6.129, P=0.007, 95%CI: 1.658~22.654) are risk factors of maximum rest MBF.Conclusion: 1.Rest MBF in women is higher than that in men. 2.The effect of aging on the reduction of CFR is more obvious than that on MBF. 3. The rest and stress MBF rather than CFR in obese people were reduced. 4. Diabetes has a greater impact on stress MBF and CFR compared with rest MBF.