Noninvasive quantification of regional blood flow in the human heart using N-13 ammonia and dynamic positron emission tomographic imaging

Gary Hutchins, Markus Schwaiger, Karen C. Rosenspire, Janine Krivokapich, Heinrich Schelbert, David E. Kuhl

Research output: Contribution to journalArticle

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Abstract

Evaluation of regional myocardial blood flow by conventional scintigraphic techniques is limited to the qualitative assessment of regional tracer distribution. Dynamic imaging with positron emission tomography allows the quantitative delineation of myocardial tracer kinetics and, hence, the measurement of physiologic processes such as myocardial blood flow. To test this hypothesis, positron emission tomographic imaging in combination with N-13 ammonia was performed at rest and after pharmacologically induced vasodilation in seven healthy volunteers. Myocardial and blood time-activity curves derived from regions of interest over the heart and ventricular chamber were fitted using a three compartment model for N-13 ammonia, yielding rate constants for tracer uptake and retention. Myocardial blood flow (K1) averaged 88 ± 17 ml/min per 100 g at rest and increased to 417 ± 112 ml/min per 100 g after dipyridamole infusion (0.56 mg/kg) and handgrip exercise. The coronary reserve averaged 4.8 ± 1.3 and was not significantly different in the septal, anterior and lateral walls of the left ventricle. Blood flow values showed only a minor dependence on the correction for blood metabolites of N-13 ammonia. These data demonstrate that quantification of regional myocardial blood flow is feasible by dynamic positron emission tomographic imaging. The observed coronary flow reserve after dipyridamole is in close agreement with the results obtained by invasive techniques, indicating accurate flow estimates over a wide range. Thus, positron emission tomography may provide accurate and noninvasive definition of the functional significance of coronary artery disease and may allow the improved selection of patients for revascularization.

Original languageEnglish (US)
Pages (from-to)1032-1042
Number of pages11
JournalJournal of the American College of Cardiology
Volume15
Issue number5
DOIs
StatePublished - 1990
Externally publishedYes

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Regional Blood Flow
Ammonia
Electrons
Dipyridamole
Positron-Emission Tomography
Vasodilation
Patient Selection
Heart Ventricles
Coronary Artery Disease
Healthy Volunteers
Exercise

ASJC Scopus subject areas

  • Nursing(all)

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Noninvasive quantification of regional blood flow in the human heart using N-13 ammonia and dynamic positron emission tomographic imaging. / Hutchins, Gary; Schwaiger, Markus; Rosenspire, Karen C.; Krivokapich, Janine; Schelbert, Heinrich; Kuhl, David E.

In: Journal of the American College of Cardiology, Vol. 15, No. 5, 1990, p. 1032-1042.

Research output: Contribution to journalArticle

Hutchins, Gary ; Schwaiger, Markus ; Rosenspire, Karen C. ; Krivokapich, Janine ; Schelbert, Heinrich ; Kuhl, David E. / Noninvasive quantification of regional blood flow in the human heart using N-13 ammonia and dynamic positron emission tomographic imaging. In: Journal of the American College of Cardiology. 1990 ; Vol. 15, No. 5. pp. 1032-1042.
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