Abstract

Aims: The longitudinal myocardial blood flow (MBF) gradient derived from positron emission tomography (PET) has been proposed as an emerging non-invasive index of haemodynamically significant coronary artery disease (CAD). This study aimed to investigate the diagnostic value of longitudinal MBF gradient for the presence of haemodynamically significant CAD. Methods and results: A total of 204 patients (603 vessels) with suspected CAD underwent [15O]H2O PET followed by invasive coronary angiography with fractional flow reserve (FFR) of all major coronary arteries. Longitudinal base-to-apex MBF gradients were assessed by two methods, using MBF in apical and mid (Method 1) or in apical and basal (Method 2) myocardial segments to calculate the gradient. The hyperaemic longitudinal MBF gradient was only weakly correlated with FFR (Method 1: r = 0.12, P = 0.02; Method 2: r = 0.22, P < 0.001). The hyperaemic longitudinal MBF gradient (by both methods), had lower diagnostic value when compared with hyperaemic MBF for the presence of haemodynamically significant CAD, defined as an FFR ≤ 0.80. No significant correlations between longitudinal MBF gradients and FFR were noted in proximal lesions, whereas longitudinal MBF gradients and FFR were significantly correlated in non-proximal lesions (r = 0.57, P < 0.001). Conclusion: PET measured longitudinal flow parameters had lower diagnostic value when compared with hyperaemic MBF for the presence of haemodynamically significant CAD. Since lesion location was found to affect the correlation of PET measured longitudinal flow parameters and FFR, presence of a longitudinal flow gradient may be partly caused by normalization to a relatively normal perfused areas.
Original languageEnglish
Pages (from-to)21-30
JournalEuropean Heart Journal-Cardiovascular Imaging
Volume20
Issue number1
Early online date12 Sep 2018
DOIs
Publication statusPublished - 1 Jan 2019

Cite this

@article{bdbab570fd3841e5b1f6e76712b12053,
title = "Diagnostic value of longitudinal flow gradient for the presence of haemodynamically significant coronary artery disease",
abstract = "Aims: The longitudinal myocardial blood flow (MBF) gradient derived from positron emission tomography (PET) has been proposed as an emerging non-invasive index of haemodynamically significant coronary artery disease (CAD). This study aimed to investigate the diagnostic value of longitudinal MBF gradient for the presence of haemodynamically significant CAD. Methods and results: A total of 204 patients (603 vessels) with suspected CAD underwent [15O]H2O PET followed by invasive coronary angiography with fractional flow reserve (FFR) of all major coronary arteries. Longitudinal base-to-apex MBF gradients were assessed by two methods, using MBF in apical and mid (Method 1) or in apical and basal (Method 2) myocardial segments to calculate the gradient. The hyperaemic longitudinal MBF gradient was only weakly correlated with FFR (Method 1: r = 0.12, P = 0.02; Method 2: r = 0.22, P < 0.001). The hyperaemic longitudinal MBF gradient (by both methods), had lower diagnostic value when compared with hyperaemic MBF for the presence of haemodynamically significant CAD, defined as an FFR ≤ 0.80. No significant correlations between longitudinal MBF gradients and FFR were noted in proximal lesions, whereas longitudinal MBF gradients and FFR were significantly correlated in non-proximal lesions (r = 0.57, P < 0.001). Conclusion: PET measured longitudinal flow parameters had lower diagnostic value when compared with hyperaemic MBF for the presence of haemodynamically significant CAD. Since lesion location was found to affect the correlation of PET measured longitudinal flow parameters and FFR, presence of a longitudinal flow gradient may be partly caused by normalization to a relatively normal perfused areas.",
keywords = "coronary artery disease, PET (positron emission tomography), PET imaging, PET quantification, FFR, myocardial blood flow, Myocardial ischemia, myocardial perfusion imaging: PET, Coronary angiography, Humans, Atherosclerosis",
author = "Bom, {Michiel J.} and Driessen, {Roel S.} and Raijmakers, {Pieter G.} and Henk Everaars and Lammertsma, {Adriaan A.} and {van Rossum}, {Albert C.} and {van Royen}, Niels and Juhani Knuuti and Maija M{\"a}ki and Ibrahim Danad and Paul Knaapen",
year = "2019",
month = "1",
day = "1",
doi = "10.1093/ehjci/jey129",
language = "English",
volume = "20",
pages = "21--30",
journal = "European Heart Journal-Cardiovascular Imaging",
issn = "2047-2404",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Diagnostic value of longitudinal flow gradient for the presence of haemodynamically significant coronary artery disease

AU - Bom, Michiel J.

AU - Driessen, Roel S.

AU - Raijmakers, Pieter G.

AU - Everaars, Henk

AU - Lammertsma, Adriaan A.

AU - van Rossum, Albert C.

AU - van Royen, Niels

AU - Knuuti, Juhani

AU - Mäki, Maija

AU - Danad, Ibrahim

AU - Knaapen, Paul

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aims: The longitudinal myocardial blood flow (MBF) gradient derived from positron emission tomography (PET) has been proposed as an emerging non-invasive index of haemodynamically significant coronary artery disease (CAD). This study aimed to investigate the diagnostic value of longitudinal MBF gradient for the presence of haemodynamically significant CAD. Methods and results: A total of 204 patients (603 vessels) with suspected CAD underwent [15O]H2O PET followed by invasive coronary angiography with fractional flow reserve (FFR) of all major coronary arteries. Longitudinal base-to-apex MBF gradients were assessed by two methods, using MBF in apical and mid (Method 1) or in apical and basal (Method 2) myocardial segments to calculate the gradient. The hyperaemic longitudinal MBF gradient was only weakly correlated with FFR (Method 1: r = 0.12, P = 0.02; Method 2: r = 0.22, P < 0.001). The hyperaemic longitudinal MBF gradient (by both methods), had lower diagnostic value when compared with hyperaemic MBF for the presence of haemodynamically significant CAD, defined as an FFR ≤ 0.80. No significant correlations between longitudinal MBF gradients and FFR were noted in proximal lesions, whereas longitudinal MBF gradients and FFR were significantly correlated in non-proximal lesions (r = 0.57, P < 0.001). Conclusion: PET measured longitudinal flow parameters had lower diagnostic value when compared with hyperaemic MBF for the presence of haemodynamically significant CAD. Since lesion location was found to affect the correlation of PET measured longitudinal flow parameters and FFR, presence of a longitudinal flow gradient may be partly caused by normalization to a relatively normal perfused areas.

AB - Aims: The longitudinal myocardial blood flow (MBF) gradient derived from positron emission tomography (PET) has been proposed as an emerging non-invasive index of haemodynamically significant coronary artery disease (CAD). This study aimed to investigate the diagnostic value of longitudinal MBF gradient for the presence of haemodynamically significant CAD. Methods and results: A total of 204 patients (603 vessels) with suspected CAD underwent [15O]H2O PET followed by invasive coronary angiography with fractional flow reserve (FFR) of all major coronary arteries. Longitudinal base-to-apex MBF gradients were assessed by two methods, using MBF in apical and mid (Method 1) or in apical and basal (Method 2) myocardial segments to calculate the gradient. The hyperaemic longitudinal MBF gradient was only weakly correlated with FFR (Method 1: r = 0.12, P = 0.02; Method 2: r = 0.22, P < 0.001). The hyperaemic longitudinal MBF gradient (by both methods), had lower diagnostic value when compared with hyperaemic MBF for the presence of haemodynamically significant CAD, defined as an FFR ≤ 0.80. No significant correlations between longitudinal MBF gradients and FFR were noted in proximal lesions, whereas longitudinal MBF gradients and FFR were significantly correlated in non-proximal lesions (r = 0.57, P < 0.001). Conclusion: PET measured longitudinal flow parameters had lower diagnostic value when compared with hyperaemic MBF for the presence of haemodynamically significant CAD. Since lesion location was found to affect the correlation of PET measured longitudinal flow parameters and FFR, presence of a longitudinal flow gradient may be partly caused by normalization to a relatively normal perfused areas.

KW - coronary artery disease

KW - PET (positron emission tomography)

KW - PET imaging

KW - PET quantification

KW - FFR

KW - myocardial blood flow

KW - Myocardial ischemia

KW - myocardial perfusion imaging: PET

KW - Coronary angiography

KW - Humans

KW - Atherosclerosis

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85058924640&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30212851

U2 - 10.1093/ehjci/jey129

DO - 10.1093/ehjci/jey129

M3 - Article

VL - 20

SP - 21

EP - 30

JO - European Heart Journal-Cardiovascular Imaging

JF - European Heart Journal-Cardiovascular Imaging

SN - 2047-2404

IS - 1

ER -