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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 2/2017

01-02-2017 | Original Article

Coronary flow reserve and relative flow reserve measured by N-13 ammonia PET for characterization of coronary artery disease

Authors: Sang-Geon Cho, Ki Seong Park, Jahae Kim, Sae-Ryung Kang, Ho-Chun Song, Ju Han Kim, Jae Yeong Cho, Young Joon Hong, Zeenat Jabin, Hee Jeong Park, Geum-Cheol Jeong, Seong Young Kwon, Jin Chul Paeng, Hyeon Sik Kim, Jung-Joon Min, Ernest V. Garcia, Henry Hee-Seung Bom

Published in: Annals of Nuclear Medicine | Issue 2/2017

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Abstract

Objective

We evaluated the relationships between coronary flow reserve (CFR) and relative flow reserve (RFR) measured by N-13 ammonia positron emission tomography (PET) for characterization of epicardial coronary artery disease (CAD).

Methods

Sixty-nine consecutive stable angina patients underwent N-13 ammonia PET, coronary computed tomography angiography (CCTA), and if necessary, invasive coronary angiography (CAG) within 2 weeks. Myocardial blood flow (MBF), CFR, RFR, and coronary vascular resistance of the reference arterial territory (CVRref) were measured by N-13 ammonia PET. The presence of significant stenosis (SS) and diffuse atherosclerosis (DA) was evaluated on CCTA and CAG. Functional parameters measured by PET were compared among arteries with and without SS and DA.

Results

Arteries with SS and those with DA showed significantly lower stress MBF, as compared to those without. RFR was significantly lower in arteries with SS as compared to those without, while CFR was not. CFR was significantly lower in arteries with DA as compared to those without, while RFR was not. Among arteries without SS, CFR was significantly lower in those with DA as compared to those without. However, among arteries with SS, CFR was similar between those with and without DA. In contrast, RFR was significantly lower in arteries with SS, regardless of the presence of DA. CFR and RFR showed a weak positive correlation (r = 0.269) with discordance in 24 cases (35%). Among the arteries with CFR-RFR discordance, the prevalence of DA was significantly higher in those with low CFR but preserved RFR, as compared to those with preserved CFR but low RFR (75 vs 25%, p = 0.028). CVRref was significantly higher in arteries with DA, implicating a correlation of DA with underlying microvascular disease.

Conclusions

CFR and RFR measured by myocardial perfusion PET could provide a comprehensive information for characterization of epicardial CAD.
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Metadata
Title
Coronary flow reserve and relative flow reserve measured by N-13 ammonia PET for characterization of coronary artery disease
Authors
Sang-Geon Cho
Ki Seong Park
Jahae Kim
Sae-Ryung Kang
Ho-Chun Song
Ju Han Kim
Jae Yeong Cho
Young Joon Hong
Zeenat Jabin
Hee Jeong Park
Geum-Cheol Jeong
Seong Young Kwon
Jin Chul Paeng
Hyeon Sik Kim
Jung-Joon Min
Ernest V. Garcia
Henry Hee-Seung Bom
Publication date
01-02-2017
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 2/2017
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-016-1138-z

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