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The diagnostic value of SPECT CZT quantitative myocardial blood flow in high-risk patients

  • ORIGINAL ARTICLE
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The objective of this study was to evaluate the accuracy of global MBF and MFR quantitation performed by myocardial perfusion scintigraphy (MPS) for the detection of multivessel coronary artery disease (CAD).

Methods

52 CAD patients underwent CZT MPS, with the evaluation of MBF and MFR, followed by invasive coronary angiography (ICA). According to MPS and ICA results, all patients were divided into three groups: (1) non-obstructive CAD and normal MPS scan (control group) (n = 7), (2) one vessel disease (1VD) (n = 16), (3) multivessel disease (MVD) (n = 29).

Results

Global absolute MBF and MFR were significantly reduced in MVD patients as compared to those with 1VD [0.93 (IQR 0.76; 1.39) vs 1.94 (1.37; 2.21) mL·min−1·g−1, P = .00012] and [1.4 (IQR 1.02; 1.85) vs 2.3 (1.8; 2.67), P = . 0 004], respectively. The Syntax score correlated with global stress MBF (ρ = − 0.64; P < .0001) and MFR (ρ = − 0.53; P = .0003). ROC analysis showed higher sensitivity and specificity for stress MBF and MFR compared with semiquantitative MPS stress evaluation. Multivariate regression analysis showed that only stress MBF [OR (95% CI) 0.59 (0.42-0.82); P < .0003] was an independent predictor of MVD.

Conclusions

Quantitative myocardial blood flow values assessed with the use of CZT camera may identify high-risk patients, such as those with multivessel disease.

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Abbreviations

AC:

Attenuation correction

CAD:

Coronary artery disease

CZT:

Cadmium-zinc-telluride

FFR:

Fractional flow reserve

ICA:

Invasive coronary angiography

MBF:

Myocardial blood flow

MFR:

Myocardial flow reserve

MPS:

Myocardial perfusion scintigraphy

MVD:

Multivessel disease

NAC:

Non-attenuation correction

PET:

Positron emission tomography

SPECT:

Single-photon emission computed tomography

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Disclosures

Authors did not have financial, personal or professional relationships with other people or organizations. Authors declare that they have no conflicts of interest.

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Author notes

    Authors and Affiliations

    1. Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Kievskaya Str 111A, Tomsk, 634012, Russia

      Konstantin V. Zavadovsky MD, Andrew V. Mochula PhD, Alina N. Maltseva MD, Alla A. Boshchenko MD, Andrew E. Baev PhD & Sergey L. Andreev PhD

    2. National Research Tomsk Polytechnic University, Tomsk, Russia

      Evgeniy A. Nesterov PhD

    3. Università di Pisa, Pisa, Italy

      Riccardo Liga MD

    4. Fondazione Toscana, CNR Gabriele Monasterio, Pisa, Italy

      Alessia Gimelli MD

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    1. Konstantin V. Zavadovsky MD
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    Contribution of Evgeniy A. Nesterov was funded by Tomsk Polytechnic University Competitiveness Enhancement Program Grant (VIU-Laboratory No. 31 YAR-221/2018, RFMEFI62019X0001).

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    Zavadovsky, K.V., Mochula, A.V., Maltseva, A.N. et al. The diagnostic value of SPECT CZT quantitative myocardial blood flow in high-risk patients. J. Nucl. Cardiol. 29, 1051–1063 (2022). https://doi.org/10.1007/s12350-020-02395-8

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