Noninvasive quantification of regional myocardial flow reserve in patients with coronary atherosclerosis using nitrogen-13 ammonia positron emission tomography

Muzik, Otto; Mélon, Pierre; Sutor, Ronald J.; Sawada, S.G.; Muller, David W.M.; Bondie, Diane; Hutchins, Gary D.; Schwaiger, Markus

doi:10.1016/0735-1097(95)00359-2

Cited by 140 publications

(69 citation statements)

References 39 publications

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“…85 Though initially established using 15 O-water, this finding was quickly replicated using 13 N-ammonia [86][87][88] and more recently using 82 Rb. 89,90 The application of stress MBF and MFR for improving the diagnostic accuracy of PET MPI with clinical protocols has been investigated by many groups with both 13 N-ammonia 47,48,88 and 82 Rb.…”

Section: Cad Diagnosismentioning

confidence: 86%

“…• In humans, resting MBF remains relatively preserved across a wide range of coronary stenosis severity, 85,86 which is largely related to the gradual autoregulatory vasodilation of resistive vessels to maintain resting myocardial perfusion in the setting of upstream stenosis. Resting MBF falls only in the presence of critical subocclusive stenosis and poorly developed collateral blood flow.…”

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

“…[85][86][87][88] The findings of human studies that have measured MBF and MFR noninvasively by PET, as well as angiographic stenosis severity, can be summarized as follows:…”

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

“…[85][86][87] • In general, hyperemic MBF and MFR are relatively preserved for coronary lesions with less than 70% angiographic stenosis or with preserved fractional flow reserve (FFR) ([ 0.8). 45,47,51,52,[85][86][87][88][89]91,141,142 However, both Figure 7. Receiver-operator characteristic curves for detection of severe CAD using MFR.…”

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

See 3 more Smart Citations

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Murthy

Bateman²,

Beanlands

et al. 2018

Journal of Nuclear Cardiology

169

111

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Section: Cad Diagnosismentioning

confidence: 86%

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

“…[85][86][87][88] The findings of human studies that have measured MBF and MFR noninvasively by PET, as well as angiographic stenosis severity, can be summarized as follows:…”

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

See 2 more Smart Citations

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Murthy

Bateman²,

Beanlands

et al. 2018

Journal of Nuclear Cardiology

169

111

View full text Add to dashboard Cite

“…Positron emission tomography (PET) measures MBF and CVR with high precision and reproducibility. The relation of these parameters to coronary stenosis has been validated with the use of Oxygen-15-water ( 15 O-H 2 O) and N-13 Ammonia ( 13 N-ammonia) as perfusion tracers (3)(4)(5). However, these radiopharmaceuticals are cyclotron products with a very short physical half-life necessitating access to a medical cyclotron.…”

Section: Introductionmentioning

confidence: 99%

Quantitative relationship between coronary vasodilator reserve assessed by 82Rb PET imaging and coronary artery stenosis severity

Anagnostopoulos

Almonacid

Fakhri

et al. 2008

Eur J Nucl Med Mol Imaging

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The relationship between myocardial blood flow (MBF) and stenosis severity has been determined previously using cyclotron-produced radiotracers such as 15 O-H 2 O and 13 N-ammonia. An attractive alternative to overcome the limitations related to the use of cyclotron might be to use the generator-produced Rubidium-82 as a flow tracer. The current study was undertaken to investigate the relationship between MBF and coronary vasodilator reserve (CVR) as measured by Rubidium-82 positron emission tomography (PET) and the percent diameter stenosis as defined by quantitative coronary arteriography.Methods-We prospectively evaluated 22 individuals: 15 patients (60±11 years of age) with angiographically documented coronary artery disease (CAD) and seven age-matched (56±9 years) asymptomatic individuals without risk factors for CAD. Dynamic Rubidium-82 PET was performed at rest and after dipyridamole vasodilation. MBF, CVR and an index of "minimal coronary resistance" (MCR) were assessed in each of the three main coronary territories.Results-Rest and stress MBF in regions subtended by vessels with <50% diameter stenosis was similar to that of the individuals with no risk factors for CAD. As a result, CVR was also similar in the two groups (1.9, interquartile [IQ] range from 1.7 to 2.7 vs. 2.2, IQ range from 2 to 3.4 respectively, p=0.09)). CVR successfully differentiated coronary lesions with stenosis severity 70% to 89% from those with 50% to 69% stenosis (1, IQ range from 1 to 1.3 vs. 1.7, IQ range from 1.4 to 2), respectively, p=0.001. In addition, hyperaemic MBF (r 2 =.74, p<0.001), CVR (r 2 =. 69, p<0.001), and MCR (r 2 =.78, p<0.001) measurements were inversely and non-linearly correlated to the percent diameter stenosis on angiography.

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Major Depression and Coronary Flow Reserve Detected by Positron Emission Tomography

et al. 2009

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Background Major depressive disorder (MDD) is associated with coronary heart disease (CHD), but the mechanisms are unclear. The presence of MDD may increase CHD risk by affecting microvascular circulation. It is also plausible that genetic factors influencing MDD may overlap with those for CHD. We sought to examine the relationship between MDD and coronary flow reserve (CFR), the ratio of maximum flow during stress to flow at rest measured in milliliters per minute per gram of tissue. Methods We examined 289 male middle-aged twins, including 106 twins (53 twin pairs) discordant for a lifetime history of MDD and 183 control twins (unrelated to any twins in the experimental group) without MDD. To calculate CFR, we used positron emission tomography with nitrogen 13 (13N) ammonia to evaluate myocardial blood flow at rest and after adenosine stress. A standard perfusion defect score was also used to assess myocardial ischemia. Results There was no difference in myocardial ischemia between twins with and without MDD. Among the dizygotic twin pairs discordant for MDD, the CFR was 14% lower in the twins with MDD than in their brothers without MDD (2.36 vs 2.74) (P=.03). This association was not present in the monozygotic discordant pairs who were genetically matched (2.86 vs 2.64) (P = .19). The zygosity-MDD interaction after adjustment was significant (P=.006). The CFR in the dizygotic twins with MDD was also lower than in the control twins. Conclusions Our results provide evidence for a shared genetic pathway between MDD and microvascular dysfunction. Common pathophysiologic processes may link MDD and early atherosclerosis.

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Noninvasive quantification of regional myocardial flow reserve in patients with coronary atherosclerosis using nitrogen-13 ammonia positron emission tomography

Cited by 140 publications

References 39 publications

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Quantitative relationship between coronary vasodilator reserve assessed by 82Rb PET imaging and coronary artery stenosis severity

Major Depression and Coronary Flow Reserve Detected by Positron Emission Tomography

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