Myocardial blood flow reserve and absolute myocardial blood flow for the assessment of patients with coronary artery disease with or without microvascular dysfunction

Giubbini, Raffaele; Cerudelli, Elisabetta; Camoni, Luca

doi:10.1007/s12350-020-02297-9

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References 26 publications

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“…Giubbini (29), but some authors reported higher values, with mean stress MBF of 3.18 ± 0.95, 2.40 ± 0.7, 3.27 ± 1.1, and 2.3 ± 0.97, respectively, for Agostini et al (8), Acampa et al (9,26), and Giubbini et al (10), whereas others observed lower values, with stress MBF of 1.11 (interquartile range, IQR: 1.00-1.26) for Nkoulou et al (7) or 0.67 (IQR, 0.55-0.81) for Zavadovsky et al (30). This discrepancy between values might result from a lack of standardization in terms of software and corrections (31).…”

Section: Discussionmentioning

confidence: 97%

Myocardial Flow Reserve Measurement During CZT-SPECT Perfusion Imaging for Coronary Artery Disease Screening: Correlation With Clinical Findings and Invasive Coronary Angiography—The CFR-OR Study

et al. 2021

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Purpose: The aim of this study was to assess the results of cadmium zinc telluride (CZT)- single-photon emission computed tomography (SPECT) myocardial flow reserve (MFR) in coronary artery disease (CAD) screening regarding clinical risk and its correlation to invasive coronary angiography (ICA).Methods: A total of 137 patients (61 male and 76 female) referred for CAD screening myocardial perfusion imaging (MPI) between November 2018 and April 2020 were included in the CFR-OR prospective trial. The 10-year risk of cardiovascular death according to the European Society of Cardiology (SCORE) was calculated. SPECT 1-day 99mTc-tetrofosmin protocol was acquired on CZT cardiac-dedicated pinhole cameras. Low-dose thoracic CT was used for coronary calcium score (CCS) evaluation. ICA, when performed within 3 months, was also analyzed.Results: Mean SCORE and mean global MFR were, respectively, 4 ± 3.1% and 2.50 ± 0.74; 34 patients had impaired CFR (using a threshold of 2). There was a significant inverse correlation between MFR and SCORE (p = 0.006), gender (p = 0.019), and number of cardiovascular risk factors (p = 0.01). MFR was significantly reduced in patients with CCS above 1 (p = 0.01). No significant correlation was found between MFR and individual cardiovascular risk factors (dyslipidemia, hypertension, diabetes, or family history of CAD). A total of 23 patients underwent ICA. Global MFR SPECT sensitivity and specificity were 83.3 and 100 %, respectively, with an area under the curve of 0.94.Conclusion: Adding MFR to SPECT MPI for CAD screening on CZT camera may contribute to high-risk patient identification and enhance diagnostic performances. MFR could help physician decision to perform ICA.

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