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Quantitative relationship between coronary calcium content and coronary flow reserve as assessed by integrated PET/CT imaging

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Abstract

Purpose

To evaluate the relationship between coronary artery calcium (CAC) and coronary vasodilator function.

Methods

We evaluated 136 patients without known coronary artery disease (CAD) undergoing vasodilator stress 82Rb PET/CT and CAC scoring who showed normal myocardial perfusion. The CAC score, resting and hyperemic myocardial blood flow (MBF), coronary flow reserve (CFR) and coronary vascular resistance were analyzed.

Results

Global and regional CAC scores showed significant but weak inverse correlations with hyperemic MBF (r=−0.31 and r=−0.26, p≤0.0002 respectively) and CFR (r=−0.28 and r=−0.2, p≤0.001 respectively). With increasing CAC score, there was a modest stepwise decline in CFR on a per-patient basis (1.8±0.5 vs 1.7±0.5 vs 1.5±0.4, p=0.048, with total CAC=0, 1–400 and >400, respectively) and on a per-vessel basis. In multivariable modeling only body mass index and CAC score were predictive of CFR.

Conclusion

In patients with an intermediate likelihood of, but without overt, CAD, there is a statistically significant but weak inverse correlation between CAC content and coronary vasodilator function. The strength of this association weakens after adjusting CAC scores for age, gender and coronary risk factors. This suggests that CAC and coronary vasodilator function provide biologically different information regarding atherosclerosis.

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Acknowledgment

The authors would like to thank Jon Hainer for his technical support on this project.

Conflicts of Interest

Sharmila Dorbala:

Speakers’ bureau: Bracco.

Speaking honoraria: GE Healthcare.

Marcelo F. Di Carli:

Research grants: Bracco, Astellas, GE Healthcare, Siemens, BMS Imaging.

Advisory boards: Bracco, BMS, GE Healthcare, Astellas.

Speaking honoraria: Bracco, GE Healthcare, Astellas.

Georges El Fakhri:

National Institutes of Health grant RO1 EB005876 funded part of the Generalized Factor Analysis of the Dynamic Sequences software development.

Zelmira Curillova, Bettina Yaman, Raymond Y. Kwong, Arkadius Sitek, Constantinos Anagnostopoulos:

None.

Author information

Author notes

  1. Zelmira Curillova

    Present address: Division of Cardiology, Department of Medicine, VA Boston Healthcare System, West Roxbury, MA, USA

Authors and Affiliations

  1. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham & Women’s Hospital, Boston, MA, USA

    Zelmira Curillova, Bettina F. Yaman, Sharmila Dorbala, Arkadius Sitek, Georges El Fakhri, Constantinos Anagnostopoulos & Marcelo F. Di Carli

  2. Division of Cardiovascular Medicine, Department of Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Raymond Y. Kwong & Marcelo F. Di Carli

  3. Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham & Women’s Hospital, Boston, MA, USA

    Sharmila Dorbala, Raymond Y. Kwong & Marcelo F. Di Carli

  4. Department of Nuclear Medicine, Royal Brompton Hospital, London, UK

    Constantinos Anagnostopoulos

  5. Division of Nuclear Medicine and Molecular Imaging, Brigham and Women’s Hospital, ASB L1-037C, 75 Francis St., Boston, MA, 02115, USA

    Marcelo F. Di Carli

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  1. Zelmira Curillova
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Corresponding author

Correspondence to Marcelo F. Di Carli.

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Curillova, Z., Yaman, B.F., Dorbala, S. et al. Quantitative relationship between coronary calcium content and coronary flow reserve as assessed by integrated PET/CT imaging. Eur J Nucl Med Mol Imaging 36, 1603–1610 (2009). https://doi.org/10.1007/s00259-009-1121-1

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  • DOI: https://doi.org/10.1007/s00259-009-1121-1

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