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European Journal of Nuclear Medicine and Molecular Imaging

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01-09-2015 | Original Article

Validation of pixel-wise parametric mapping of myocardial blood flow with ¹³NH₃ PET in patients with hypertrophic cardiomyopathy

Authors: Roberto Sciagrà, Alessandro Passeri, Fabrizio Cipollini, Helga Castagnoli, Iacopo Olivotto, Cyrill Burger, Franco Cecchi, Alberto Pupi

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2015

Abstract

Purpose

Transmural abnormalities in myocardial blood flow (MBF) are important causes of ischaemia in patients with left ventricular (LV) hypertrophy. The study aimed to test whether pixel-wise parametric mapping of ¹³NH₃ MBF can reveal transmural abnormalities in patients with hypertrophic cardiomyopathy (HCM).

Methods

We submitted 11 HCM patients and 9 age-matched controls with physiological LV hypertrophy to rest and stress (dipyridamole) ¹³NH₃ PET. We measured MBF using a compartmental model, and obtained rest and stress parametric maps. Pixel MBF values were reorganized to obtain subendocardial and subepicardial MBF of LV segments.

Results

MBF at rest was higher in the subendocardial than in the subepicardial layer: 0.78 ± 0.19 vs. 0.60 ± 0.18 mL/min/g in HCM patients; 0.92 ± 0.24 vs. 0.75 ± 0.24 mL/min/g in controls (both p < 0.0001). Transmural perfusion gradient (TPG = subendocardial MBF/subepicardial MBF) at rest was similar: 1.35 ± 0.31 in HCM patients; 1.28 ± 0.27 in controls (NS). During stress, controls maintained higher subendocardial MBF: 2.44 ± 0.54 vs. 1.96 ± 0.67 mL/min/g tissue (p < 0.0001), with a TPG of 1.33 ± 0.35 (NS vs. rest). In HCM patients, the difference between subendocardial and subepicardial MBF was reduced (1.46 ± 0.48 vs. 1.36 ± 0.48 mL/min/g tissue, p < 0.01) and TPG decreased to 1.11 ± 0.34 (p < 0.0001 vs. rest and vs. controls). In HCM patients 8 of 176 segments had subendocardial MBF less than −2 × SD of the mean, versus none of 144 segments in controls (p < 0.01).

Conclusion

Pixel-wise parametric mapping of ¹³NH₃ MBF enables the identification of transmural abnormalities in patients with HCM.

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Title: Validation of pixel-wise parametric mapping of myocardial blood flow with 13NH3 PET in patients with hypertrophic cardiomyopathy
Authors: Roberto Sciagrà
Alessandro Passeri
Fabrizio Cipollini
Helga Castagnoli
Iacopo Olivotto
Cyrill Burger
Franco Cecchi
Alberto Pupi
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3101-y

At a glance: The STEP trials

Springer Medicine

Validation of pixel-wise parametric mapping of myocardial blood flow with ¹³NH₃ PET in patients with hypertrophic cardiomyopathy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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