Skip to main content
Top
Published in: European Journal of Nuclear Medicine and Molecular Imaging 5/2017

01-05-2017 | Editorial Commentary

Radionuclide imaging of subendocardial ischaemia: an insight into coronary pathophysiology or a technical artefact?

Authors: Gianmario Sambuceti, Silvia Morbelli, Alessandro Bellini, Cecilia Marini

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2017

Login to get access

Excerpt

In the present issue of the European Journal of Nuclear Medicine and Molecular Imaging, Sciagrà and coworkers report an investigation of the mechanisms underlying a decrease in left ventricular (LV) ejection fraction during dipyridamole-induced coronary vasodilation in a group of patients with hypertrophic cardiomyopathy (HCM) [1]. As a major finding, transient LV dysfunction did not identify patients with more severe impairment in coronary flow reserve and maximal blood flow. Rather, it was associated with stress-induced development of a transmural gradient in myocardial perfusion characterized by a relative reduction in maximal flow capacity in the subendocardial layers. …
Literature
1.
go back to reference Sciagrà R, Calabretta R, Cipollini F, Passeri A, Castello A, Cecchi F, et al. Myocardial blood flow and left ventricular functional reserve in hypertrophic cardiomyopathy: a 13NH3 gated PET study. Eur J Nucl Med Mol Imaging. 2017. doi:10.1007/s00259-016-3603-2. Sciagrà R, Calabretta R, Cipollini F, Passeri A, Castello A, Cecchi F, et al. Myocardial blood flow and left ventricular functional reserve in hypertrophic cardiomyopathy: a 13NH3 gated PET study. Eur J Nucl Med Mol Imaging. 2017. doi:10.​1007/​s00259-016-3603-2.
3.
4.
go back to reference Ross Jr J. Electrocardiographic ST-segment analysis in the characterization of myocardial ischemia and infarction. Circulation. 1976;53(3 Suppl):I73–I81.PubMed Ross Jr J. Electrocardiographic ST-segment analysis in the characterization of myocardial ischemia and infarction. Circulation. 1976;53(3 Suppl):I73–I81.PubMed
5.
go back to reference Downey JM, Kirk ES. Inhibition of coronary blood flow by a vascular waterfall mechanism. Circ Res. 1975;36:753–760.CrossRefPubMed Downey JM, Kirk ES. Inhibition of coronary blood flow by a vascular waterfall mechanism. Circ Res. 1975;36:753–760.CrossRefPubMed
6.
go back to reference Hoffman JI, Spaan JA. Pressure-flow relations in coronary circulation. Physiol Rev. 1990;70:331–390.PubMed Hoffman JI, Spaan JA. Pressure-flow relations in coronary circulation. Physiol Rev. 1990;70:331–390.PubMed
7.
go back to reference Meerdink DJ, Okada RD, Leppo JA. The effect of dipyridamole on transmural blood flow gradients. Chest. 1989;96:400–405.CrossRefPubMed Meerdink DJ, Okada RD, Leppo JA. The effect of dipyridamole on transmural blood flow gradients. Chest. 1989;96:400–405.CrossRefPubMed
8.
go back to reference Gistri R, Cecchi F, Choudhury L, Montereggi A, Sorace O, Salvadori PA, et al. Effect of verapamil treatment on absolute myocardial blood flow in hypertrophic cardiomyopathy. Am J Cardiol. 1994;74:363–368.CrossRefPubMed Gistri R, Cecchi F, Choudhury L, Montereggi A, Sorace O, Salvadori PA, et al. Effect of verapamil treatment on absolute myocardial blood flow in hypertrophic cardiomyopathy. Am J Cardiol. 1994;74:363–368.CrossRefPubMed
9.
go back to reference Knaapen P, Germans T, Camici PG, Rimoldi OE, ten Cate FJ, ten Berg JM, et al. Determinants of coronary microvascular dysfunction in symptomatic hypertrophic cardiomyopathy. Am J Physiol Heart Circ Physiol. 2008;294(2):H986–93. Knaapen P, Germans T, Camici PG, Rimoldi OE, ten Cate FJ, ten Berg JM, et al. Determinants of coronary microvascular dysfunction in symptomatic hypertrophic cardiomyopathy. Am J Physiol Heart Circ Physiol. 2008;294(2):H986–93.
10.
go back to reference Rajappan K, Rimoldi OE, Dutka DP, Ariff B, Pennell DJ, Sheridan DJ, et al. Mechanisms of coronary microcirculatory dysfunction in patients with aortic stenosis and angiographically normal coronary arteries. Circulation. 2002;105(4):470–476.CrossRefPubMed Rajappan K, Rimoldi OE, Dutka DP, Ariff B, Pennell DJ, Sheridan DJ, et al. Mechanisms of coronary microcirculatory dysfunction in patients with aortic stenosis and angiographically normal coronary arteries. Circulation. 2002;105(4):470–476.CrossRefPubMed
12.
go back to reference Danad I, Raijmakers PG, Harms HJ, Heymans MW, van Royen N, Lubberink M, et al. Impact of anatomical and functional severity of coronary atherosclerotic plaques on the transmural perfusion gradient: a [15O]H2O PET study. Eur Heart J. 2014;35(31):2094–2105. doi:10.1093/eurheartj/ehu170.CrossRefPubMed Danad I, Raijmakers PG, Harms HJ, Heymans MW, van Royen N, Lubberink M, et al. Impact of anatomical and functional severity of coronary atherosclerotic plaques on the transmural perfusion gradient: a [15O]H2O PET study. Eur Heart J. 2014;35(31):2094–2105. doi:10.​1093/​eurheartj/​ehu170.CrossRefPubMed
13.
go back to reference Vermeltfoort IA, Raijmakers PG, Lubberink M, Germans T, van Rossum AC, Lammertsma AA, et al. Feasibility of subendocardial and subepicardial myocardial perfusion measurements in healthy normals with (15)O-labeled water and positron emission tomography. J Nucl Cardiol. 2011;18:650–656.CrossRefPubMedPubMedCentral Vermeltfoort IA, Raijmakers PG, Lubberink M, Germans T, van Rossum AC, Lammertsma AA, et al. Feasibility of subendocardial and subepicardial myocardial perfusion measurements in healthy normals with (15)O-labeled water and positron emission tomography. J Nucl Cardiol. 2011;18:650–656.CrossRefPubMedPubMedCentral
14.
go back to reference Rimoldi O, Schafers KP, Boellaard R, Turkheimer F, Stegger L, Law MP, et al. Quantification of subendocardial and subepicardial blood flow using 15O-labeled water and PET: experimental validation. J Nucl Med. 2006;47:163–172.PubMed Rimoldi O, Schafers KP, Boellaard R, Turkheimer F, Stegger L, Law MP, et al. Quantification of subendocardial and subepicardial blood flow using 15O-labeled water and PET: experimental validation. J Nucl Med. 2006;47:163–172.PubMed
15.
go back to reference Heymann MA, Payne BD, Hoffman JI, Rudolph AM. Blood flow measurements with radionuclide-labeled particles. Prog Cardiovasc Dis. 1977;20(1):55–79.CrossRefPubMed Heymann MA, Payne BD, Hoffman JI, Rudolph AM. Blood flow measurements with radionuclide-labeled particles. Prog Cardiovasc Dis. 1977;20(1):55–79.CrossRefPubMed
16.
go back to reference Parodi O, Sambuceti G, Roghi A, Testa R, Inglese E, Pirelli S, et al. Residual coronary reserve despite decreased resting blood flow in patients with critical coronary lesions. A study by technetium-99m human albumin microsphere myocardial scintigraphy. Circulation. 1993;87:330–344.CrossRefPubMed Parodi O, Sambuceti G, Roghi A, Testa R, Inglese E, Pirelli S, et al. Residual coronary reserve despite decreased resting blood flow in patients with critical coronary lesions. A study by technetium-99m human albumin microsphere myocardial scintigraphy. Circulation. 1993;87:330–344.CrossRefPubMed
17.
go back to reference Levin GS, Hoffman EJ. Calculation of positron range and its effect on the fundamental limit of positron emission tomography system spatial resolution. Phys Med Biol. 1999;44:781–799.CrossRefPubMed Levin GS, Hoffman EJ. Calculation of positron range and its effect on the fundamental limit of positron emission tomography system spatial resolution. Phys Med Biol. 1999;44:781–799.CrossRefPubMed
18.
go back to reference Sambuceti G, Marzilli M, Mari A, Marini C, Schluter M, Testa R, et al. Coronary microcirculatory vasoconstriction is heterogeneously distributed in acutely ischemic myocardium. Am J Physiol Heart Circ Physiol. 2005;288:H2298–H2305.CrossRefPubMed Sambuceti G, Marzilli M, Mari A, Marini C, Schluter M, Testa R, et al. Coronary microcirculatory vasoconstriction is heterogeneously distributed in acutely ischemic myocardium. Am J Physiol Heart Circ Physiol. 2005;288:H2298–H2305.CrossRefPubMed
19.
go back to reference Lautamäki R, George RT, Kitagawa K, Higuchi T, Merrill J, Voicu C, et al. Rubidium-82 PET-CT for quantitative assessment of myocardial blood flow: validation in a canine model of coronary artery stenosis. Eur J Nucl Med Mol Imaging. 2009;36:576–586. doi:10.1007/s00259-008-0972-1.CrossRefPubMed Lautamäki R, George RT, Kitagawa K, Higuchi T, Merrill J, Voicu C, et al. Rubidium-82 PET-CT for quantitative assessment of myocardial blood flow: validation in a canine model of coronary artery stenosis. Eur J Nucl Med Mol Imaging. 2009;36:576–586. doi:10.​1007/​s00259-008-0972-1.CrossRefPubMed
20.
go back to reference Sherif HM, Nekolla SG, Saraste A, Reder S, Yu M, Robinson S, et al. Simplified quantification of myocardial flow reserve with flurpiridaz F18: validation with microspheres in a pig model. J Nucl Med. 2011;52:617–624. doi:10.2967/jnumed.110.083196.CrossRefPubMed Sherif HM, Nekolla SG, Saraste A, Reder S, Yu M, Robinson S, et al. Simplified quantification of myocardial flow reserve with flurpiridaz F18: validation with microspheres in a pig model. J Nucl Med. 2011;52:617–624. doi:10.​2967/​jnumed.​110.​083196.CrossRefPubMed
21.
go back to reference Bellina CR, Parodi O, Camici P, Salvadori PA, Taddei L, Fusani L, et al. Simultaneous in vitro and in vivo validation of nitrogen-13-ammonia for the assessment of regional myocardial blood flow. J Nucl Med. 1990;31:1335–1343.PubMed Bellina CR, Parodi O, Camici P, Salvadori PA, Taddei L, Fusani L, et al. Simultaneous in vitro and in vivo validation of nitrogen-13-ammonia for the assessment of regional myocardial blood flow. J Nucl Med. 1990;31:1335–1343.PubMed
22.
go back to reference Marcassa C, Marzullo P, Parodi O, Sambuceti G, L’Abbate A. A new method for noninvasive quantitation of segmental myocardial wall thickening using technetium-99m 2-methoxy-isobutyl-isonitrile scintigraphy – results in normal subjects. J Nucl Med. 1990;31:173–177.PubMed Marcassa C, Marzullo P, Parodi O, Sambuceti G, L’Abbate A. A new method for noninvasive quantitation of segmental myocardial wall thickening using technetium-99m 2-methoxy-isobutyl-isonitrile scintigraphy – results in normal subjects. J Nucl Med. 1990;31:173–177.PubMed
Metadata
Title
Radionuclide imaging of subendocardial ischaemia: an insight into coronary pathophysiology or a technical artefact?
Authors
Gianmario Sambuceti
Silvia Morbelli
Alessandro Bellini
Cecilia Marini
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2017
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-017-3642-3

Other articles of this Issue 5/2017

European Journal of Nuclear Medicine and Molecular Imaging 5/2017 Go to the issue