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01-02-2017 | Original Article

Hybrid CCTA/SPECT myocardial perfusion imaging findings in patients with anomalous origin of coronary arteries from the opposite sinus and suspected concomitant coronary artery disease

Authors: Christoph Gräni, MD, Dominik C. Benz, MD, Christian Schmied, MD, Jan Vontobel, MD, Fran Mikulicic, MD, Mathias Possner, MD, Olivier F. Clerc, MD, Julia Stehli, MD, Tobias A. Fuchs, MD, Aju P. Pazhenkottil, MD, Oliver Gaemperli, MD, Ronny R. Buechel, MD, Philipp A. Kaufmann, MD

Published in: Journal of Nuclear Cardiology | Issue 1/2017

Abstract

Background

Anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS) are associated with adverse cardiac events. Discrimination between ACAOS and coronary artery disease (CAD)-related perfusion defects may be difficult. The aim of the present study was to investigate the value of hybrid coronary computed tomography angiography (CCTA)/SPECT-MPI in patients with ACAOS and possible concomitant CAD.

Methods

We retrospectively identified 46 patients (mean age 56 ± 12 years) with ACAOS revealed by CCTA who underwent additional SPECT-MPI. ACAOS with an interarterial course were classified as malignant, whereas all other variants were considered benign. CCTA/SPECT-MPI hybrid imaging findings (ischemia or scar) were analyzed according to the territory subtended by an anomalous vessel or a stenotic coronary artery.

Results

Twenty-six (57%) patients presented with malignant ACAOS. Myocardial ischemia or scar was found only in patients who had concomitant obstructive CAD in the vessel matching the perfusion defect as evidenced by hybrid CCTA/SPECT imaging.

Conclusion

Hybrid CCTA/SPECT-MPI represents a valuable non-invasive tool to discriminate the impact of ACAOS from concomitant CAD on myocardial ischemia. Our results suggest that in a middle-aged population myocardial ischemia due to ACAOS per se may be exceedingly rare and is more likely attributable to concomitant CAD.

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Title: Hybrid CCTA/SPECT myocardial perfusion imaging findings in patients with anomalous origin of coronary arteries from the opposite sinus and suspected concomitant coronary artery disease
Authors: Christoph Gräni, MD
Dominik C. Benz, MD
Christian Schmied, MD
Jan Vontobel, MD
Fran Mikulicic, MD
Mathias Possner, MD
Olivier F. Clerc, MD
Julia Stehli, MD
Tobias A. Fuchs, MD
Aju P. Pazhenkottil, MD
Oliver Gaemperli, MD
Ronny R. Buechel, MD
Philipp A. Kaufmann, MD
Publication date: 01-02-2017
Publisher: Springer US
Published in: Journal of Nuclear Cardiology / Issue 1/2017
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-015-0342-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hybrid CCTA/SPECT myocardial perfusion imaging findings in patients with anomalous origin of coronary arteries from the opposite sinus and suspected concomitant coronary artery disease

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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