RT Journal Article
SR Electronic
T1 Structural Abnormalities of the Coronary Arterial Wall—in Addition to Luminal Narrowing—Affect Myocardial Blood Flow Reserve
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1704
OP 1712
DO 10.2967/jnumed.111.091009
VO 52
IS 11
A1 Riccardo Liga
A1 Cecilia Marini
A1 Michele Coceani
A1 Elena Filidei
A1 Mathis Schlueter
A1 Massimiliano Bianchi
A1 Giuseppe Rossi
A1 Silvia Pardini
A1 Piero Salvadori
A1 Oberdan Parodi
A1 Daniele Rovai
A1 Gianmario Sambuceti
A1 Paolo Marraccini
A1 Danilo Neglia
YR 2011
UL http://jnm.snmjournals.org/content/52/11/1704.abstract
AB Multislice CT provides information on coronary luminal narrowing and on the structural abnormalities of the coronary arterial wall using densitometric analysis. We sought to investigate the effects of coronary luminal narrowing, structural abnormalities of the coronary arterial wall, and cardiovascular risk factors on regional and global myocardial blood flow (MBF) reserve. Methods: We studied 68 patients (mean age ± SD, 61 ± 10 y; 41 men, 27 women) with an intermediate probability of coronary artery disease. We measured the severity of coronary stenoses and the fibroadipose, fibromuscular, and calcium components of the coronary arterial wall by 64-row multislice CT coronary angiography. We also measured regional and global MBF reserve by PET using 13N-ammonia as a flow tracer at rest and after dipyridamole. Results: One or more significant coronary stenoses (≥50% luminal narrowing) was present in 32 patients (47%), and nonsignificant stenoses were present in 15 patients (22%). Regional MBF reserve was significantly different in the territories perfused by normal coronary arteries, nonsignificant coronary stenoses, and significant coronary stenoses (P < 0.001). Calcium content was higher in the coronary arteries with significant or nonsignificant stenoses (0.95% ± 1.08% and 0.73% ± 0.93%, respectively) than in those without stenoses (0.11% ± 0.38%, P < 0.001). Significant coronary stenosis (P = 0.047) and calcium content (P = 0.017) were the only independent determinants of impaired regional MBF reserve using multivariate analysis. At multiple logistic regression analysis, the Framingham risk score, an index of global cardiovascular risk burden, was the only significant determinant of global MBF reserve (P = 0.028). Conclusion: Coronary stenoses and coronary calcium content independently affect regional MBF reserve. Framingham risk score is the only significant determinant of global MBF reserve.