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Geographic and demographic variabilities of quantitative parameters in stress myocardial computed tomography perfusion

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Background/Aims: To evaluate the geographic and demographic variabilities of the quantitative parameters of computed tomography perfusion (CTP) of the left ventricular (LV) myocardium in patients with normal coronary artery on computed tomography angiography (CTA). Methods: From a multicenter CTP registry of stress and static computed tomography, we retrospectively recruited 113 patients (mean age, 60 years; 57 men) without perfusion defect on visual assessment and minimal (< 20% of diameter stenosis) or no coronary artery disease on CTA. Using semiautomatic analysis software, quantitative parameters of the LV myocardium, including the myocardial attenuation in stress and rest phases, transmural perfusion ratio (TPR), and myocardial perfusion reserve index (MPRI), were evaluated in 16 myocardial segments. Results: In the lateral wall of the LV myocardium, all quantitative parameters except for MPRI were significantly higher compared with those in the other walls. The MPRI showed consistent values in all myocardial walls (anterior to lateral wall: range, 25% to 27%; p = 0.401). At the basal level of the myocardium, all quantitative parameters were significantly lower than those at the mid- and apical levels. Compared with men, women had significantly higher values of myocardial attenuation and TPR. Age, body mass index, and Framingham risk score were significantly associated with the difference in myocardial attenuation. Conclusions: Geographic and demographic variabilities of quantitative parameters in stress myocardial CTP exist in healthy subjects without significant coronary artery disease. This information may be helpful when assessing myocardial perfusion defects in CTP.

Abstract

Background/Aims: To evaluate the geographic and demographic variabilities of the quantitative parameters of computed tomography perfusion (CTP) of the left ventricular (LV) myocardium in patients with normal coronary artery on computed tomography angiography (CTA). Methods: From a multicenter CTP registry of stress and static computed tomography, we retrospectively recruited 113 patients (mean age, 60 years; 57 men) without perfusion defect on visual assessment and minimal (< 20% of diameter stenosis) or no coronary artery disease on CTA. Using semiautomatic analysis software, quantitative parameters of the LV myocardium, including the myocardial attenuation in stress and rest phases, transmural perfusion ratio (TPR), and myocardial perfusion reserve index (MPRI), were evaluated in 16 myocardial segments. Results: In the lateral wall of the LV myocardium, all quantitative parameters except for MPRI were significantly higher compared with those in the other walls. The MPRI showed consistent values in all myocardial walls (anterior to lateral wall: range, 25% to 27%; p = 0.401). At the basal level of the myocardium, all quantitative parameters were significantly lower than those at the mid- and apical levels. Compared with men, women had significantly higher values of myocardial attenuation and TPR. Age, body mass index, and Framingham risk score were significantly associated with the difference in myocardial attenuation. Conclusions: Geographic and demographic variabilities of quantitative parameters in stress myocardial CTP exist in healthy subjects without significant coronary artery disease. This information may be helpful when assessing myocardial perfusion defects in CTP.

참고문헌 (16)

  1. Kim YH, "Impact of ischemia-guided revascularization with myocardial perfusion imaging for patients with multivessel coronary disease.", J Am Coll Cardiol, 60, pp.181~190 (2012)
  2. William F. Fearon, "Physiologic approach for coronary intervention", The Korean Journal of Internal Medicine, 28(1), pp.1~7 (2013), 대한내과학회[DOI]
  3. Hachamovitch R, "Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography", Circulation, 107, pp.2900~2907 (2003)
  4. Ko BS, "Computed tomography stress myocardial perfusion imaging in patients considered for revascularization: a comparison with fractional flow reserve", Eur Heart J, 33, pp.67~77 (2012)
  5. Ko BS, "Combined CT coronary angiography and stress myocardial perfusion imaging for hemodynamically significant stenoses in patients with suspected coronary artery disease: a comparison with fractional flow reserve", JACC Cardiovasc Imaging, 5, pp.1097~1111 (2012)
  6. George RT, "Adenosine stress 64- and 256-row detector computed tomography angiography and perfusion imaging: a pilot study evaluating the transmural extent of perfusion abnormalities to predict atherosclerosis causing myocardial ischemia", Circ Cardiovasc Imaging, 2, pp.174~182 (2009)
  7. Cury RC, "Dipyridamole stress and rest transmural myocardial perfusion ratio evaluation by 64 detector-row computed tomography", J Cardiovasc Comput Tomogr, 5, pp.443~448 (2011)
  8. Kitagawa K, "Characterization and correction of beam-hardening artifacts during dynamic volume CT assessment of myocardial perfusion", Radiology, 256, pp.111~118 (2010)
  9. Stanton CL, "Normal myocardial perfusion on 64-detector resting cardiac CT", J Cardiovasc Comput Tomogr, 5, pp.52~60 (2011)
  10. Byrne C, "Sex- and age-related differences of myocardial perfusion at rest assessed with multidetector computed tomography", J Cardiovasc Comput Tomogr, 7, pp.94~101 (2013)
  11. Rodriguez-Granillo GA, "Signal density of left ventricular myocardial segments and impact of beam hardening artifact: implications for myocardial perfusion assessment by multidetector CT coronary angiography", Int J Cardiovasc Imaging, 26, pp.345~354 (2010)
  12. Crossett MP, "Normal perfusion of the left ventricular myocardium using 320MDCT", J Cardiovasc Comput Tomogr, 5, pp.406~411 (2011)
  13. Vaccarino V, "Ischaemic heart disease in women: are there sex differences in pathophysiology and risk factors? Position paper from the working group on coronary pathophysiology and microcirculation of the European Society of Cardiology", Cardiovasc Res, 90, pp.9~17 (2011)
  14. Mendelsohn ME, "The protective effects of estrogen on the cardiovascular system", N Engl J Med, 340, pp.1801~1811 (1999)
  15. Bae KT, "Contrast enhancement in cardiovascular MDCT: effect of body weight, height, body surface area, body mass index, and obesity", AJR Am J Roentgenol, 190, pp.777~784 (2008)
  16. Cullen JH, "A myocardial perfusion reserve index in humans using first-pass contrast-enhanced magnetic resonance imaging", J Am Coll Cardiol, 33, pp.1386~1394 (1999)

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