The diagnostic value of SPECT CZT quantitative myocardial blood flow in high-risk patients
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Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Tomsk, Russia National Research Tomsk Polytechnic University, Tomsk, Russia ` di Pisa, Pisa, Italy Universita Fondazione Toscana, CNR Gabriele Monasterio, Pisa, Italy
Received May 25, 2020; accepted Sep 21, 2020 doi:10.1007/s12350-020-02395-8
Background. The objective of this study was to evaluate the accuracy of global MBF and MFR quantitation performed by myocardial perfusion scintigraphy (MPS) for the detection of multivessel coronary artery disease (CAD). Methods. 52 CAD patients underwent CZT MPS, with the evaluation of MBF and MFR, followed by invasive coronary angiography (ICA). According to MPS and ICA results, all patients were divided into three groups: (1) non-obstructive CAD and normal MPS scan (control group) (n = 7), (2) one vessel disease (1VD) (n = 16), (3) multivessel disease (MVD) (n = 29). Results. Global absolute MBF and MFR were significantly reduced in MVD patients as compared to those with 1VD [0.93 (IQR 0.76; 1.39) vs 1.94 (1.37; 2.21) mLmin21g21, P = .00012] and [1.4 (IQR 1.02; 1.85) vs 2.3 (1.8; 2.67), P = . 0 004], respectively. The Syntax score correlated with global stress MBF (q = 2 0.64; P < .0001) and MFR (q = 2 0.53; P = .0003). ROC analysis showed higher sensitivity and specificity for stress MBF and MFR compared with semiquantitative MPS stress evaluation. Multivariate regression analysis showed that only stress MBF [OR (95% CI) 0.59 (0.42-0.82); P < .0003] was an independent predictor of MVD. Conclusions. Quantitative myocardial blood flow values assessed with the use of CZT camera may identify high-risk patients, such as those with multivessel disease. (J Nucl Cardiol 2020) Key Words: Multivessel disease Æ SPECT Æ CZT Æ CAD Æ myocardial ischemia Æ myocardial blood flow Æ myocardial flow reserve
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02395-8) contains supplementary material, which is available to authorized users. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com. The authors have also provided an audio summary of the article, which is available to download as ESM, or to listen to via the JNC/ASNC Podcast. Funding Contribution of Evgeniy A. Nesterov was funded by Tomsk Polytechnic University Competitiveness Enhancement
Program Grant (VIU-Laboratory RFMEFI62019X0001).
No.
31
YAR-221/2018,
Reprint requests: Konstantin V. Zavadovsky, MD, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Kievskaya Str 111A, Tomsk 634012, Russia; [email protected] 1071-3581/$34.00 Copyright Ó 2020 American Society of Nuclear Cardiology.
Zavadovsky et al The diagnostic value of SPECT CZT quantitative myocardial blood flow
Abbreviations AC Attenuation correction CAD Coronary arte
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