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. 2007 Sep-Oct;14(5):688-97.
doi: 10.1016/j.nuclcard.2007.06.120.

Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction

Thomas H Schindler  1 , Xiao-Li Zhang, Gabriella Vincenti, Leila Mhiri, Rene Nkoulou, Hanjoerg Just, Osman Ratib, Francois Mach, Magnus Dahlbom, Heinrich R Schelbert
Affiliations

Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction

Thomas H Schindler et al. J Nucl Cardiol. 2007 Sep-Oct.

Abstract

Background: We aimed to evaluate the diagnostic value of a positron emission tomography (PET)-measured heterogeneity in longitudinal myocardial blood flow (MBF) during cold pressor testing (CPT) and global MBF response to CPT from rest (DeltaMBF) for identification of coronary vasomotor dysfunction.

Methods and results: In 35 patients CPT-induced alterations in epicardial luminal area were determined with quantitative angiography as the reference. MBF was assessed over the whole left ventricle as global MBF and regionally in the mid and mid-distal myocardium as MBF difference or MBF heterogeneity with nitrogen-13 ammonia and PET. The sensitivity and specificity of a longitudinal MBF difference during CPT in the identification of epicardial vasomotor dysfunction were significantly higher than the global DeltaMBF to CPT (88% vs 79% and 82% vs 64%, respectively; P < .05). Combining both parameters resulted in an optimal sensitivity of 100% at the expense of an intermediate specificity of 73%. The diagnostic accuracy was higher for the combined analysis than that for the MBF difference alone and global DeltaMBF alone (91% vs 86% and 74%, respectively; P < .05).

Conclusions: The combined evaluation of a CPT-induced heterogeneity in longitudinal MBF and the change in global MBF from rest may emerge as a new promising analytic approach to further optimize the identification and characterization of coronary vasomotor dysfunction.

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Conflict of interest statement

Conflict of interest disclosure: The authors do not have any conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
Schematic representation of polar maps of MBFs and assignment of regions of interest (ROI). A, three coronary artery territories; B, circumferential ROIs for mid (B) and mid-distal (A) portion of LV. LAD indicates left anterior descending; LCx, left circumflex and RCA, right coronary artery.
Fig. 2
Fig. 2
MBFs at rest and during CPT mid and mid-distal portions of the LV myocardium for the two study groups.
Fig. 3
Fig. 3
Correlation between (A) MBF difference and change in LA (ΔLA) during CPT.
Fig. 4
Fig. 4
Schematic representation of the sensitivity, specifity and diagnostic accuracy of PET-measured MBF alterations during CPT in the identification of epicardial vasomotor dysfunction.
See this image and copyright information in PMC

References

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