Quantification of regional myocardial perfusion by PET: Rationale and first clinical results

M. Schwaiger, Gary Hutchins

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

With the recent advances in interventional cardiology there is increasing need for characterization of the functional effects of coronary artery stenosis. Stress echocardiography and SPECT perfuson imaging are standard techniques for the qualitative assessment of regional regional function and perfusion in patients with proven or suspected coronary artery disease. However, positron emission tomography (PET) provides quantitative measurements of regional myocardial perfusion. In combination with pharmacological stress testing, relative and absolute coronary reserve measurements can be used to define functional significance of regional coronary artery disease. First clinical results indicate that there is an overall agreement between angiographic and functional disease severity. However, there is a relatively large scatter of coronary reserve flow in patients with 50-90% coronary artery stenosis, which emphasizes the complimentary role of perfusion imaging in the prediction of functional severity. In addition, first studies in asymptomatic patients with a high risk for coronary artery disease suggest that PET coronary reserve flow measurement may be more sensitive than angiographic criteria for detection of early alterations in coronary vascular reactivity. Absolute quantification of blood flow may be useful in disease processes which affect the entire left ventricle such as vasculopathy in cardiac transplants as well as endothelial dysfunction in patients with hypertension and cardiomyopathy. Future studies have to demonstrate the prognostic value of the quantitative estimate of coronary reserve as regards clinical outcome in patients with various coronary abnormalities. Quantitative flow measurements will be useful for monitoring progression and regression of coronary artery disease as well as assessment of acute and chronic therapy.

Original languageEnglish (US)
Pages (from-to)84-91
Number of pages8
JournalEuropean Heart Journal
Volume16
Issue numberSUPPL. J
StatePublished - 1995
Externally publishedYes

Fingerprint

Positron-Emission Tomography
Perfusion
Coronary Artery Disease
Coronary Stenosis
Stress Echocardiography
Perfusion Imaging
Single-Photon Emission-Computed Tomography
Cardiology
Cardiomyopathies
Heart Ventricles
Blood Vessels
Pharmacology
Hypertension
Transplants
Therapeutics

Keywords

  • Coronary artery disease
  • Coronary flow reserve
  • Myocardial perfusion
  • N-13 ammonia
  • Positron emission tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Quantification of regional myocardial perfusion by PET : Rationale and first clinical results. / Schwaiger, M.; Hutchins, Gary.

In: European Heart Journal, Vol. 16, No. SUPPL. J, 1995, p. 84-91.

Research output: Contribution to journalArticle

@article{6a02b7428845478daaeb7494a65158b5,
title = "Quantification of regional myocardial perfusion by PET: Rationale and first clinical results",
abstract = "With the recent advances in interventional cardiology there is increasing need for characterization of the functional effects of coronary artery stenosis. Stress echocardiography and SPECT perfuson imaging are standard techniques for the qualitative assessment of regional regional function and perfusion in patients with proven or suspected coronary artery disease. However, positron emission tomography (PET) provides quantitative measurements of regional myocardial perfusion. In combination with pharmacological stress testing, relative and absolute coronary reserve measurements can be used to define functional significance of regional coronary artery disease. First clinical results indicate that there is an overall agreement between angiographic and functional disease severity. However, there is a relatively large scatter of coronary reserve flow in patients with 50-90{\%} coronary artery stenosis, which emphasizes the complimentary role of perfusion imaging in the prediction of functional severity. In addition, first studies in asymptomatic patients with a high risk for coronary artery disease suggest that PET coronary reserve flow measurement may be more sensitive than angiographic criteria for detection of early alterations in coronary vascular reactivity. Absolute quantification of blood flow may be useful in disease processes which affect the entire left ventricle such as vasculopathy in cardiac transplants as well as endothelial dysfunction in patients with hypertension and cardiomyopathy. Future studies have to demonstrate the prognostic value of the quantitative estimate of coronary reserve as regards clinical outcome in patients with various coronary abnormalities. Quantitative flow measurements will be useful for monitoring progression and regression of coronary artery disease as well as assessment of acute and chronic therapy.",
keywords = "Coronary artery disease, Coronary flow reserve, Myocardial perfusion, N-13 ammonia, Positron emission tomography",
author = "M. Schwaiger and Gary Hutchins",
year = "1995",
language = "English (US)",
volume = "16",
pages = "84--91",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "SUPPL. J",

}

TY - JOUR

T1 - Quantification of regional myocardial perfusion by PET

T2 - Rationale and first clinical results

AU - Schwaiger, M.

AU - Hutchins, Gary

PY - 1995

Y1 - 1995

N2 - With the recent advances in interventional cardiology there is increasing need for characterization of the functional effects of coronary artery stenosis. Stress echocardiography and SPECT perfuson imaging are standard techniques for the qualitative assessment of regional regional function and perfusion in patients with proven or suspected coronary artery disease. However, positron emission tomography (PET) provides quantitative measurements of regional myocardial perfusion. In combination with pharmacological stress testing, relative and absolute coronary reserve measurements can be used to define functional significance of regional coronary artery disease. First clinical results indicate that there is an overall agreement between angiographic and functional disease severity. However, there is a relatively large scatter of coronary reserve flow in patients with 50-90% coronary artery stenosis, which emphasizes the complimentary role of perfusion imaging in the prediction of functional severity. In addition, first studies in asymptomatic patients with a high risk for coronary artery disease suggest that PET coronary reserve flow measurement may be more sensitive than angiographic criteria for detection of early alterations in coronary vascular reactivity. Absolute quantification of blood flow may be useful in disease processes which affect the entire left ventricle such as vasculopathy in cardiac transplants as well as endothelial dysfunction in patients with hypertension and cardiomyopathy. Future studies have to demonstrate the prognostic value of the quantitative estimate of coronary reserve as regards clinical outcome in patients with various coronary abnormalities. Quantitative flow measurements will be useful for monitoring progression and regression of coronary artery disease as well as assessment of acute and chronic therapy.

AB - With the recent advances in interventional cardiology there is increasing need for characterization of the functional effects of coronary artery stenosis. Stress echocardiography and SPECT perfuson imaging are standard techniques for the qualitative assessment of regional regional function and perfusion in patients with proven or suspected coronary artery disease. However, positron emission tomography (PET) provides quantitative measurements of regional myocardial perfusion. In combination with pharmacological stress testing, relative and absolute coronary reserve measurements can be used to define functional significance of regional coronary artery disease. First clinical results indicate that there is an overall agreement between angiographic and functional disease severity. However, there is a relatively large scatter of coronary reserve flow in patients with 50-90% coronary artery stenosis, which emphasizes the complimentary role of perfusion imaging in the prediction of functional severity. In addition, first studies in asymptomatic patients with a high risk for coronary artery disease suggest that PET coronary reserve flow measurement may be more sensitive than angiographic criteria for detection of early alterations in coronary vascular reactivity. Absolute quantification of blood flow may be useful in disease processes which affect the entire left ventricle such as vasculopathy in cardiac transplants as well as endothelial dysfunction in patients with hypertension and cardiomyopathy. Future studies have to demonstrate the prognostic value of the quantitative estimate of coronary reserve as regards clinical outcome in patients with various coronary abnormalities. Quantitative flow measurements will be useful for monitoring progression and regression of coronary artery disease as well as assessment of acute and chronic therapy.

KW - Coronary artery disease

KW - Coronary flow reserve

KW - Myocardial perfusion

KW - N-13 ammonia

KW - Positron emission tomography

UR - http://www.scopus.com/inward/record.url?scp=0028843904&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028843904&partnerID=8YFLogxK

M3 - Article

C2 - 8746944

AN - SCOPUS:0028843904

VL - 16

SP - 84

EP - 91

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - SUPPL. J

ER -