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Quantitative myocardial perfusion should be interpreted in the light of sex and co-morbidities in patients with suspected chronic coronary syndrome - a cardiac positron emission tomography study

Székely, Anna LU ; Steding-Ehrenborg, Katarina LU ; Ryd, Daniel LU ; Hedeer, Fredrik LU ; Valind, Kristian LU orcid ; Akil, Shahnaz LU ; Hindorf, Cecilia LU ; Hedström, Erik LU orcid ; Erlinge, David LU orcid and Arheden, Håkan LU , et al. (2024) In Clinical Physiology and Functional Imaging 44(1). p.89-99
Abstract

Diagnosis and treatment of patients with suspected chronic coronary syndrome (CCS) currently relies on the degree of coronary artery stenosis and its significance for myocardial perfusion. However, myocardial perfusion can be affected by factors other than coronary stenosis. The aim of this study was to investigate to what extent sex, age, diabetes, hypertension and smoking affect quantitative myocardial perfusion, beyond the degree of coronary artery stenosis, in patients with suspected CCS. Eighty-six patients (median age 69 [range 46-86] years, 24 females) planned for elective coronary angiography due to suspected CCS were included. All patients underwent cardiac 13 N-NH3 Positron Emission Tomography to quantify myocardial perfusion... (More)

Diagnosis and treatment of patients with suspected chronic coronary syndrome (CCS) currently relies on the degree of coronary artery stenosis and its significance for myocardial perfusion. However, myocardial perfusion can be affected by factors other than coronary stenosis. The aim of this study was to investigate to what extent sex, age, diabetes, hypertension and smoking affect quantitative myocardial perfusion, beyond the degree of coronary artery stenosis, in patients with suspected CCS. Eighty-six patients (median age 69 [range 46-86] years, 24 females) planned for elective coronary angiography due to suspected CCS were included. All patients underwent cardiac 13 N-NH3 Positron Emission Tomography to quantify myocardial perfusion at rest and stress. Lowest myocardial perfusion (perfusionmin ) at stress and rest and lowest myocardial perfusion reserve (MPRmin ) for all vessel territories was used as dependent variables in a linear mixed model. Independent variables were vessel territory, degree of coronary artery stenosis (as a continuous variable of 0-100% stenosis), sex, age, diabetes, hypertension and smoking habits. Degree of coronary artery stenosis (P<0.001), male sex (1.8±0.6 vs 2.3±0.6 ml/min/g, P<0.001), increasing age (P=0.03), diabetes (1.6±0.5 vs 2.0±0.6 ml/min/g, P=0.02) and smoking (1.9±0.6 vs 2.1±0.6 ml/min/g, P=0.05) were independently associated with myocardial perfusionmin at stress. Degree of coronary artery stenosis (P<0.001), age (P=0.05), diabetes (1.8±0.6 vs 2.3±0.7, P=0.05) and hypertension (2.2±0.7 vs 2.5±0.6, P=0.03) were independently associated with MPRmin . Sex, increasing age, diabetes, hypertension and smoking affect myocardial perfusion independent of coronary artery stenosis in patients with suspected CCS. Thus, these factors need to be considered when assessing the significance of reduced quantitative myocardial perfusion of patients with suspected CCS. This article is protected by copyright. All rights reserved.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Physiology and Functional Imaging
volume
44
issue
1
pages
89 - 99
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85170400033
  • pmid:37642142
ISSN
1475-0961
DOI
10.1111/cpf.12854
language
English
LU publication?
yes
additional info
This article is protected by copyright. All rights reserved.
id
eb725960-e9f5-4d3b-978d-a92c22ce53d8
date added to LUP
2023-09-08 11:44:31
date last changed
2024-04-20 03:00:18
@article{eb725960-e9f5-4d3b-978d-a92c22ce53d8,
  abstract     = {{<p>Diagnosis and treatment of patients with suspected chronic coronary syndrome (CCS) currently relies on the degree of coronary artery stenosis and its significance for myocardial perfusion. However, myocardial perfusion can be affected by factors other than coronary stenosis. The aim of this study was to investigate to what extent sex, age, diabetes, hypertension and smoking affect quantitative myocardial perfusion, beyond the degree of coronary artery stenosis, in patients with suspected CCS. Eighty-six patients (median age 69 [range 46-86] years, 24 females) planned for elective coronary angiography due to suspected CCS were included. All patients underwent cardiac 13 N-NH3 Positron Emission Tomography to quantify myocardial perfusion at rest and stress. Lowest myocardial perfusion (perfusionmin ) at stress and rest and lowest myocardial perfusion reserve (MPRmin ) for all vessel territories was used as dependent variables in a linear mixed model. Independent variables were vessel territory, degree of coronary artery stenosis (as a continuous variable of 0-100% stenosis), sex, age, diabetes, hypertension and smoking habits. Degree of coronary artery stenosis (P&lt;0.001), male sex (1.8±0.6 vs 2.3±0.6 ml/min/g, P&lt;0.001), increasing age (P=0.03), diabetes (1.6±0.5 vs 2.0±0.6 ml/min/g, P=0.02) and smoking (1.9±0.6 vs 2.1±0.6 ml/min/g, P=0.05) were independently associated with myocardial perfusionmin at stress. Degree of coronary artery stenosis (P&lt;0.001), age (P=0.05), diabetes (1.8±0.6 vs 2.3±0.7, P=0.05) and hypertension (2.2±0.7 vs 2.5±0.6, P=0.03) were independently associated with MPRmin . Sex, increasing age, diabetes, hypertension and smoking affect myocardial perfusion independent of coronary artery stenosis in patients with suspected CCS. Thus, these factors need to be considered when assessing the significance of reduced quantitative myocardial perfusion of patients with suspected CCS. This article is protected by copyright. All rights reserved.</p>}},
  author       = {{Székely, Anna and Steding-Ehrenborg, Katarina and Ryd, Daniel and Hedeer, Fredrik and Valind, Kristian and Akil, Shahnaz and Hindorf, Cecilia and Hedström, Erik and Erlinge, David and Arheden, Håkan and Engblom, Henrik}},
  issn         = {{1475-0961}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{89--99}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Clinical Physiology and Functional Imaging}},
  title        = {{Quantitative myocardial perfusion should be interpreted in the light of sex and co-morbidities in patients with suspected chronic coronary syndrome - a cardiac positron emission tomography study}},
  url          = {{http://dx.doi.org/10.1111/cpf.12854}},
  doi          = {{10.1111/cpf.12854}},
  volume       = {{44}},
  year         = {{2024}},
}