1. Dynamic CT myocardial perfusion imaging identifies early perfusion abnormalities in diabetes and hypertension: Insights from a multicenter registry.
- Author
-
Vliegenthart R, De Cecco CN, Wichmann JL, Meinel FG, Pelgrim GJ, Tesche C, Ebersberger U, Pugliese F, Bamberg F, Choe YH, Wang Y, and Schoepf UJ
- Subjects
- Aged, Asia, Blood Flow Velocity, Coronary Artery Disease etiology, Coronary Artery Disease physiopathology, Coronary Vessels physiopathology, Diabetic Angiopathies etiology, Diabetic Angiopathies physiopathology, Early Diagnosis, Europe, Female, Humans, Hypertension diagnosis, Male, Middle Aged, Predictive Value of Tests, Prognosis, Registries, Retrospective Studies, Risk Assessment, Risk Factors, United States, Computed Tomography Angiography, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Coronary Circulation, Coronary Vessels diagnostic imaging, Diabetic Angiopathies diagnostic imaging, Hypertension complications, Myocardial Perfusion Imaging methods
- Abstract
Background: To identify patients with early signs of myocardial perfusion reduction, a reference base for perfusion measures is needed., Objective: To analyze perfusion parameters derived from dynamic computed tomography perfusion imaging (CTPI) in patients with suspected coronary artery disease (CAD), and relationship with risk factors., Methods: In this multicenter study, coronary CT angiography (cCTA) and dynamic CTPI were performed by second-generation dual-source CT in patients suspected of CAD. Risk factors were collected from hospital records. Patients with visual perfusion defects on CTPI, previous coronary intervention, or missing risk factor details were excluded. This analysis included 98 patients (mean age ± standard deviation [SD], 59.0 ± 8.6yrs; 73 male). Global measures of left ventricular myocardial blood flow (MBF), myocardial blood volume (MBV) and volume transfer constant (K(trans)) were calculated., Results: Mean MBF was 139.3 ± 31.4 mL/100 mL/min, MBV 19.1 ± 2.7 mL/100 mL, and Ktrans 85.0 ± 17.5 mL/100 mL/min. No significant differences in perfusion parameters were found by gender or age category. Hypertension and diabetes mellitus resulted in lower perfusion parameters (hypertension vs normotension: MBV 18.5 ± 3.0 vs 19.7 ± 2.3 mL/100 mL and K(trans) 82.0 ± 18.0 vs 89.0 ± 16.0, p < 0.05; diabetes vs no diabetes: MBF 128.5 ± 31.5 vs 144.0 ± 30.5 mL/100 mL/min and MBV 17.9 ± 2.4 vs 19.4 ± 2.8 mL/100 mL, p < 0.05). In patients with hyperlipidemia, MBF was higher (146.8 ± 34.4 vs 130.7 ± 24.3 mL/100 mL/min, p < 0.05). Smoking and family history did not show perfusion parameter differences., Conclusions: Dynamic CTPI identifies early perfusion disturbances in conditions like diabetes and hypertension. With further standardization, absolute perfusion measures may improve CAD risk stratification in patients without visual perfusion defects., (Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF