The Value of Quantitative Myocardial Perfusion Imaging with Positron Emission Tomography in Coronary Artery Disease

Overview

Journal Herz

Specialty Cardiology & Vascular Diseases

Date 1997 Apr 1

PMID 9134442

Citations 1

Authors

W Wijns

P G Camici

Affiliations

Soon will be listed here.

Abstract

Positron Emission Tomography (PET) is the only available technique that permits quantification of regional myocardial perfusion in humans. To this end, tracer kinetic models and appropriate tracers such as 13N-Ammonia and 15O labeled water are required. Quantification is possible because accurate radioactivity quantities can be measured externally, both for the vascular and myocardial compartments. Normal value for baseline and maximal perfusion after pharmacologically induced vasodilatation of the resistance microcirculatory vessels are age-dependent. The functional hemodynamic significance of epicardial stenoses can be estimated from the progressive reduction in coronary perfusion reserve, which decreases progressively when stenosis severity reaches 40% in diameter. The effect of revascularization procedures such as CABG and PTCA can be objectively measured. In addition, there is increasing evidence from PET studies that resistive vessel dysfunction (probably through endothelial factors) contributes to the reduced perfusion reserve in patients with epicardial coronary artery disease. Therefore quantification of myocardial perfusion with PET appears an ideally suited endpoint for primary and secondary prevention trials.

Citing Articles

Myocardial perfusion quantitation with 15O-labelled water PET: high reproducibility of the new cardiac analysis software (Carimas).

Nesterov S, Han C, Maki M, Kajander S, Naum A, Helenius H Eur J Nucl Med Mol Imaging. 2009; 36(10):1594-602.

PMID: 19408000 DOI: 10.1007/s00259-009-1143-8.

References

Klocke F . Measurements of coronary flow reserve: defining pathophysiology versus making decisions about patient care. Circulation. 1987; 76(6):1183-9. DOI: 10.1161/01.cir.76.6.1183. View

Schwaiger M . Myocardial perfusion imaging with PET. J Nucl Med. 1994; 35(4):693-8. View

Uren N, Camici P, Melin J, Bol A, de Bruyne B, Radvan J . Effect of aging on myocardial perfusion reserve. J Nucl Med. 1995; 36(11):2032-6. View

Hermansen F, Ashburner J, Spinks T, Kooner J, Camici P, Lammertsma A . Generation of myocardial factor images directly from the dynamic oxygen-15-water scan without use of an oxygen-15-carbon monoxide blood-pool scan. J Nucl Med. 1998; 39(10):1696-702. View

Uren N, Marraccini P, Gistri R, De Silva R, Camici P . Altered coronary vasodilator reserve and metabolism in myocardium subtended by normal arteries in patients with coronary artery disease. J Am Coll Cardiol. 1993; 22(3):650-8. DOI: 10.1016/0735-1097(93)90172-w. View

Hutchins G, Schwaiger M, Rosenspire K, Krivokapich J, Schelbert H, Kuhl D . Noninvasive quantification of regional blood flow in the human heart using N-13 ammonia and dynamic positron emission tomographic imaging. J Am Coll Cardiol. 1990; 15(5):1032-42. DOI: 10.1016/0735-1097(90)90237-j. View

Seiler C, Hess O, Buechi M, Suter T, KRAYENBUEHL H . Influence of serum cholesterol and other coronary risk factors on vasomotion of angiographically normal coronary arteries. Circulation. 1993; 88(5 Pt 1):2139-48. DOI: 10.1161/01.cir.88.5.2139. View

Ghaleh B, Shen Y, Vatner S . Spatial heterogeneity of myocardial blood flow presages salvage versus necrosis with coronary artery reperfusion in conscious baboons. Circulation. 1996; 94(9):2210-5. DOI: 10.1161/01.cir.94.9.2210. View

Sambuceti G, Parodi O, Marcassa C, Neglia D, Salvadori P, Giorgetti A . Alteration in regulation of myocardial blood flow in one-vessel coronary artery disease determined by positron emission tomography. Am J Cardiol. 1993; 72(7):538-43. DOI: 10.1016/0002-9149(93)90348-g. View

10.

Vanoverschelde J, Melin J, Bol A, Vanbutsele R, Cogneau M, Labar D . Regional oxidative metabolism in patients after recovery from reperfused anterior myocardial infarction. Relation to regional blood flow and glucose uptake. Circulation. 1992; 85(1):9-21. DOI: 10.1161/01.cir.85.1.9. View

11.

Gistri R, Cecchi F, Choudhury L, Montereggi A, Sorace O, Salvadori P . Effect of verapamil on absolute myocardial blood flow in hypertrophic cardiomyopathy. Am J Cardiol. 1994; 74(4):363-8. DOI: 10.1016/0002-9149(94)90404-9. View

12.

Uren N, Crake T, Lefroy D, De Silva R, Davies G, Maseri A . Reduced coronary vasodilator function in infarcted and normal myocardium after myocardial infarction. N Engl J Med. 1994; 331(4):222-7. DOI: 10.1056/NEJM199407283310402. View

13.

Schelbert H, Buxton D . Insights into coronary artery disease gained from metabolic imaging. Circulation. 1988; 78(3):496-505. DOI: 10.1161/01.cir.78.3.496. View

14.

Detre K, Peduzzi P, Murphy M, Hultgren H, Thomsen J, Oberman A . Effect of bypass surgery on survival in patients in low- and high-risk subgroups delineated by the use of simple clinical variables. Circulation. 1981; 63(6):1329-38. DOI: 10.1161/01.cir.63.6.1329. View

15.

Gould K . Reversal of coronary atherosclerosis. Clinical promise as the basis for noninvasive management of coronary artery disease. Circulation. 1994; 90(3):1558-71. DOI: 10.1161/01.cir.90.3.1558. View

16.

Dayanikli F, Grambow D, Muzik O, Mosca L, Rubenfire M, Schwaiger M . Early detection of abnormal coronary flow reserve in asymptomatic men at high risk for coronary artery disease using positron emission tomography. Circulation. 1994; 90(2):808-17. DOI: 10.1161/01.cir.90.2.808. View

17.

Krivokapich J, Smith G, Huang S, Hoffman E, Ratib O, Phelps M . 13N ammonia myocardial imaging at rest and with exercise in normal volunteers. Quantification of absolute myocardial perfusion with dynamic positron emission tomography. Circulation. 1989; 80(5):1328-37. DOI: 10.1161/01.cir.80.5.1328. View

18.

Maseri A, Crea F, Cianflone D . Myocardial ischemia caused by distal coronary vasoconstriction. Am J Cardiol. 1992; 70(20):1602-5. DOI: 10.1016/0002-9149(92)90464-a. View

19.

Brown B, Zhao X, Sacco D, Albers J . Lipid lowering and plaque regression. New insights into prevention of plaque disruption and clinical events in coronary disease. Circulation. 1993; 87(6):1781-91. DOI: 10.1161/01.cir.87.6.1781. View

20.

Gould K, Westcott R, Albro P, Hamilton G . Noninvasive assessment of coronary stenoses by myocardial imaging during pharmacologic coronary vasodilatation. II. Clinical methodology and feasibility. Am J Cardiol. 1978; 41(2):279-87. DOI: 10.1016/0002-9149(78)90166-2. View