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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

  • Original Articles
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Journal of Nuclear Cardiology Aims and scope

Abstract

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.

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Authors and Affiliations

  1. Department of Nuclear Cardiology, Cardiovascular Center, University Hospital of Geneva, Geneva, Switzerland

    Thomas H. Schindler, Gabriella Vincenti, Leila Mhiri, Rene Nkoulou, Osman Ratib & Francois Mach

  2. Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, Calif

    Thomas H. Schindler, Xiao-Li Zhang, Magnus Dahlbom & Heinrich R. Schelbert

  3. Medical Center, University Hospital Freiburg, Freiburg, Germany

    Hanjoerg Just

Authors
  1. Thomas H. Schindler
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  2. Xiao-Li Zhang
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  3. Gabriella Vincenti
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  4. Leila Mhiri
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  5. Rene Nkoulou
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  6. Hanjoerg Just
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  7. Osman Ratib
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  8. Francois Mach
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  9. Magnus Dahlbom
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  10. Heinrich R. Schelbert
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Corresponding author

Correspondence to Thomas H. Schindler.

Additional information

This work was supported in part by National Institutes of Health grant HL 33177 from the National Heart, Lung, and Blood Institute and by a grant from the government of Baden-Wuerttemberg, Germany, for the Center of Clinical Research II: Cardiovascular Diseases: Analysis and Integration of Form and Function at Albert-Ludwig-University Freiburg (project THS-A1/A2).

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Schindler, T.H., Zhang, XL., Vincenti, G. et al. Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction. J Nucl Cardiol 14, 688–697 (2007). https://doi.org/10.1016/j.nuclcard.2007.06.120

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  • DOI: https://doi.org/10.1016/j.nuclcard.2007.06.120

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