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Appropriate coronary revascularization can be accomplished if myocardial perfusion is quantified by positron emission tomography prior to treatment decision

Akil, Shahnaz LU ; Hedeer, Fredrik LU ; Oddstig, Jenny LU ; Olsson, Thomas ; Jögi, Jonas LU orcid ; Erlinge, David LU orcid ; Carlsson, Marcus LU ; Arheden, Håkan LU ; Hindorf, Cecilia LU and Engblom, Henrik LU (2021) In Journal of Nuclear Cardiology 28(4). p.1664-1672
Abstract

Background: Many patients undergo percutaneous coronary intervention (PCI) without the use of non-invasive stress testing prior to treatment. The aim of this study was to determine the potential added value of guiding revascularization by quantitative assessment of myocardial perfusion prior to intervention. 

Methods and Results: Thirty-three patients (10 females) with suspected or established CAD who had been referred for a clinical coronary angiography (CA) with possibility for PCI were included. Adenosine stress and rest 13N-NH3 PET, cardiac magnetic resonance (CMR), and cardiopulmonary exercise test were performed 4 ± 3 weeks before and 5 ± 1 months after CA. The angiographer was blinded to the PET and... (More)

Background: Many patients undergo percutaneous coronary intervention (PCI) without the use of non-invasive stress testing prior to treatment. The aim of this study was to determine the potential added value of guiding revascularization by quantitative assessment of myocardial perfusion prior to intervention. 

Methods and Results: Thirty-three patients (10 females) with suspected or established CAD who had been referred for a clinical coronary angiography (CA) with possibility for PCI were included. Adenosine stress and rest 13N-NH3 PET, cardiac magnetic resonance (CMR), and cardiopulmonary exercise test were performed 4 ± 3 weeks before and 5 ± 1 months after CA. The angiographer was blinded to the PET and CMR results. Myocardial flow reserve (MFR) < 2.0 by PET was considered abnormal. A PCI was performed in 19/33 patients. In 41% (11/27) of the revascularized vessel territories, a normal regional MFR was found prior to the PCI and no improvement in MFR was found at follow-up (P = 0.9). However, vessel territories with regional MFR < 2.0 at baseline improved significantly after PCI (P = 0.003). Of the 14 patients not undergoing PCI, four had MFR < 2.0 in one or more coronary territories. 

Conclusion: Assessment of quantitative myocardial perfusion prior to revascularization could lead to more appropriate use of CA when managing patients with stable CAD.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coronary angiography, Coronary artery disease, revascularization, stress imaging
in
Journal of Nuclear Cardiology
volume
28
issue
4
pages
9 pages
publisher
Springer
external identifiers
  • pmid:31705424
  • scopus:85075151757
ISSN
1071-3581
DOI
10.1007/s12350-019-01938-y
language
English
LU publication?
yes
id
85f64307-a207-45e9-9481-03980e7cd4ea
date added to LUP
2019-12-13 09:42:35
date last changed
2025-01-10 03:49:20
@article{85f64307-a207-45e9-9481-03980e7cd4ea,
  abstract     = {{<p>Background: Many patients undergo percutaneous coronary intervention (PCI) without the use of non-invasive stress testing prior to treatment. The aim of this study was to determine the potential added value of guiding revascularization by quantitative assessment of myocardial perfusion prior to intervention. </p><p>Methods and Results: Thirty-three patients (10 females) with suspected or established CAD who had been referred for a clinical coronary angiography (CA) with possibility for PCI were included. Adenosine stress and rest <sup>13</sup>N-NH<sub>3</sub> PET, cardiac magnetic resonance (CMR), and cardiopulmonary exercise test were performed 4 ± 3 weeks before and 5 ± 1 months after CA. The angiographer was blinded to the PET and CMR results. Myocardial flow reserve (MFR) &lt; 2.0 by PET was considered abnormal. A PCI was performed in 19/33 patients. In 41% (11/27) of the revascularized vessel territories, a normal regional MFR was found prior to the PCI and no improvement in MFR was found at follow-up (P = 0.9). However, vessel territories with regional MFR &lt; 2.0 at baseline improved significantly after PCI (P = 0.003). Of the 14 patients not undergoing PCI, four had MFR &lt; 2.0 in one or more coronary territories. </p><p>Conclusion: Assessment of quantitative myocardial perfusion prior to revascularization could lead to more appropriate use of CA when managing patients with stable CAD.</p>}},
  author       = {{Akil, Shahnaz and Hedeer, Fredrik and Oddstig, Jenny and Olsson, Thomas and Jögi, Jonas and Erlinge, David and Carlsson, Marcus and Arheden, Håkan and Hindorf, Cecilia and Engblom, Henrik}},
  issn         = {{1071-3581}},
  keywords     = {{coronary angiography; Coronary artery disease; revascularization; stress imaging}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{4}},
  pages        = {{1664--1672}},
  publisher    = {{Springer}},
  series       = {{Journal of Nuclear Cardiology}},
  title        = {{Appropriate coronary revascularization can be accomplished if myocardial perfusion is quantified by positron emission tomography prior to treatment decision}},
  url          = {{http://dx.doi.org/10.1007/s12350-019-01938-y}},
  doi          = {{10.1007/s12350-019-01938-y}},
  volume       = {{28}},
  year         = {{2021}},
}