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Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction

Schindler, Thomas ; Zhang, Xiao-Li ; Vincenti, Gabriella ; Mhiri, Leila ; Nkoulou, Rene ; Just, Hanjoerg ; Ratib, Osman ; Mach, Francois ; Dahlbom, Magnus ; Schelbert, Heinrich

In: Journal of Nuclear Cardiology, 2007, vol. 14, no. 5, p. 688-697

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    Titre
    • Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction
    Auteur
    • Schindler, Thomas. Department of Nuclear Cardiology, Cardiovascular Center, University Hospital of Geneva, Geneva, Switzerland
    • Zhang, Xiao-Li. Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, Calif
    • Vincenti, Gabriella. Department of Nuclear Cardiology, Cardiovascular Center, University Hospital of Geneva, Geneva, Switzerland
    • Mhiri, Leila. Department of Nuclear Cardiology, Cardiovascular Center, University Hospital of Geneva, Geneva, Switzerland
    • Nkoulou, Rene. Department of Nuclear Cardiology, Cardiovascular Center, University Hospital of Geneva, Geneva, Switzerland
    • Just, Hanjoerg. Medical Center, University Hospital Freiburg, Freiburg, Germany
    • Ratib, Osman. Department of Nuclear Cardiology, Cardiovascular Center, University Hospital of Geneva, Geneva, Switzerland
    • Mach, Francois. Department of Nuclear Cardiology, Cardiovascular Center, University Hospital of Geneva, Geneva, Switzerland
    • Dahlbom, Magnus. Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, Calif
    • Schelbert, Heinrich. Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, Calif
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:322240
    Summary
    Background: We aimed to evaluate the diagnostic value of a positron emission tomography (PET)-measured heterogeneity in longitudinal myocardial blood flow (MBF) during cold pressor testing (CPT) and global MBF response to CPT from rest (ΔMBF) for identification of coronary vasomotor dysfunction. Methods and Results: In 35 patients CPT-induced alterations in epicardial luminal area were determined with quantitative angiography as the reference. MBF was assessed over the whole left ventricle as global MBF and regionally in the mid and mid-distal myocardium as MBF difference or MBF heterogeneity with nitrogen-13 ammonia and PET. The sensitivity and specificity of a longitudinal MBF difference during CPT in the identification of epicardial vasomotor dysfunction were significantly higher, than the global ΔMBF to CPT (88% vs 79% and 82% vs 64%, respectively; P<.05). Combining both parameters resulted in an optimal sensitivity of 100% at the expense of an intermediate specificity of 73%. The diagnostic accuracy was higher for the combined analysis than that for the MBF difference alone and global ΔMBF alone (91% vs 86% and 74%, respectively; P<.05). Conclusions: The combined evaluation of a CPT-induced heterogeneity in longitudinal MBF and the change in global MBF from rest may emerge as a new promising analytic approach to further optimize the identification and characterization of coronary vasomotor dysfunction