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Dynamic perfusion SPECT for functional evaluation in symptomatic patients with myocardial bridging

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The aim of this study was to investigate the feasibility and diagnostic value of myocardial flow reserve (MFR) assessed by rest/stress myocardial perfusion imaging with dynamic single-photon emission computed tomography (SPECT) in the functional evaluation of myocardial bridge (MB).

Methods

From May 2017 to July 2021, patients with angiographically confirmed isolated MB on the left anterior descending artery (LAD) who underwent dynamic SPECT myocardial perfusion imaging were retrospectively included. The assessment of semiquantitative indices of myocardial perfusion (summed stress scores, SSS) and quantitative parameters (MFR) was performed.

Results

A total of 49 patients were enrolled. The mean age of the subjects was 61.0 ± 9.0 years. All of the patients were symptomatic, and 16 cases (32.7%) presented with typical angina. SPECT-derived MFR showed a borderline significantly negative correlation with SSS (r = 0.261, P = .070). There was a trend of higher prevalence of impaired myocardial perfusion defined as MFR < 2 than as SSS ≥ 4 (42.9% vs 26.5%; P = .090).

Conclusion

Our data support that SPECT MFR may be a useful parameter for the functional assessment of MB. In patients with MB, the use of dynamic SPECT could be a potential method for hemodynamic assessment.

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Abbreviations

MB:

Myocardial bridging

LAD:

Left anterior descending artery

MFR:

Myocardial flow reserve

CZT:

Cadmium-zinc-telluride

MBF:

Myocardial blood flow

DS:

Diameter stenosis

QCA:

Quantitative coronary angiography

ROI:

Region of interest

SSS:

Summed stress scores

ROC:

Receiver operating characteristic

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Acknowledgements

This work was supported by grant from the National Natural Science Foundation of China (No. 81770429) and Shanghai Pujiang Program (Nos. 22PJD011 and 22PJD012).

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Author notes

  1. Rende Xu and Hao Yang have contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Rende Xu MD, Hao Yang MD, Yizhe Wu MD, PhD, Zhiqiang Pei MD, Chenguang Li MD, PhD & Junbo Ge MD, PhD

  2. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Jie Zhang MD, PhD, Shuguang Chen BSc, Lifang Pang MD, PhD & Hongcheng Shi MD, PhD

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  1. Rende Xu MD
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Correspondence to Chenguang Li MD, PhD or Junbo Ge MD, PhD.

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Xu, R., Yang, H., Zhang, J. et al. Dynamic perfusion SPECT for functional evaluation in symptomatic patients with myocardial bridging. J. Nucl. Cardiol. 30, 2058–2067 (2023). https://doi.org/10.1007/s12350-023-03241-3

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