Normal values of myocardial blood flow measured with dynamic myocardial computed tomography perfusion.

Aims: Dynamic myocardial computed tomography (CT) perfusion (DM-CTP) can, in combination with coronary CT angiography (CCTA), provide anatomical and functional evaluation of coronary artery disease (CAD). However, normal values of myocardial blood flow (MBF) are needed to identify impaired myocardial blood supply in patients with suspected CAD. We aimed to establish normal values for MBF measured using DM-CTP, to assess the effects of age and sex, and to assess regional distribution of MBF.
Methods and Results: A total of 82 healthy individuals (46 women) aged 45-78 years with normal coronary arteries by CCTA underwent either rest and adenosine stress DM-CTP (n = 30) or adenosine-induced stress DM-CTP only (n = 52). Global and segmental MBF were assessed. Global MBF at rest and during stress were 0.93 ± 0.42 and 3.58 ± 1.14 mL/min/g, respectively. MBF was not different between the sexes (P = 0.88 at rest and P = 0.61 during stress), and no correlation was observed between MBF and age (P = 0.08 at rest and P = 0.82 during stress). Among the 16 myocardial segments, significant intersegmental differences were found (P < 0.01), which was not related to age, sex, or coronary dominance.
Conclusion: MBF assessed by DM-CTP in healthy individuals with normal coronary arteries displays significant intersegmental heterogeneity which does not seem to be affected by age, sex, or coronary dominance. Normal values of MBF may be helpful in the clinical evaluation of suspected myocardial ischaemia using DM-CTP.
Competing Interests: Conflict of interest: M.B.M. received personal grants from the Rigshospitalets Research Foundation and the Heart Center Research Council, Rigshospitalet. J.J.L. has received grants from the Danish Research Foundation and the Research Council of Rigshospitalet during the conduct of the study. A.F. reports no conflicts of interest. B.G.N. has received consulting fees or honoraria for presentations by AstraZeneca, Sanofi, Regeneron, Akcea, Amgen, Kowa, Denka Seiken, Amarin, Novartis, Novo Nordisk, Abbott, and Silence Therap. L.V.K. has received grants from the Danish Research Foundation during the conduct of the study. K.F.K. has received grants from Sygeforsikring ‘Danmark’, The Danish Agency for Science, Technology and Innovation, The Danish Council for Strategic Research, The University of Copenhagen, The Danish Heart Foundation, The Danish Research Foundation, The Research Council of Rigshospitalet, AP Moller og hustru Chastine McKinney Mollers Fond, The John and Birthe Meyer Foundation, The Lundbeck Foundation, and Canon Medical Systems Corporation. K.F.K. is on the Speakers Bureau of Canon Medical Systems Corporation. The funding sources did not have any role in the study design, conduct of the study, data analysis, data interpretation, or writing of this report.
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