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Myocardial perfusion assessed with cardiac computed tomography in women without coronary heart disease

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Bechsgaard, Daria Frestad ; Gustafsson, Ida ; Linde, Jesper James ; Kofoed, Klaus Fuglsang ; Prescott, Eva ; Hove, Jens Dahlgaard. / Myocardial perfusion assessed with cardiac computed tomography in women without coronary heart disease. I: Clinical Physiology and Functional Imaging. 2019 ; Bind 39, Nr. 1. s. 65-77.

Bibtex

@article{3506bb74fb4440eeb494c22cc16f9d55,
title = "Myocardial perfusion assessed with cardiac computed tomography in women without coronary heart disease",
abstract = "PURPOSE: Combined coronary CT angiography and CT perfusion (CTP) is a novel, non-invasive, 'one-stop' diagnostic tool to rule out ischaemia in patients suspected for coronary artery disease (CAD). However, the normal myocardial perfusion pattern by static CTP in humans is poorly described. We aimed to investigate global and regional myocardial perfusion during rest and adenosine-induced hyperaemia in asymptomatic women without history of coronary heart disease (CHD).METHODS: Using a 320-row CT scanner with a static protocol, semi-quantitative assessment of rest and stress CTP was performed in 34 asymptomatic middle-aged women without obstructive CAD (<50% stenosis) or history of CHD, and with normal exercise stress test and left ventricular (LV) function. Using a 16-segment model, we assessed global and regional values of LV myocardial perfusion reserve (MPR) and transmural perfusion ratio (TPR).RESULTS: Mean±SD age was 56 ± 13 years. Resting and hyperaemic myocardial perfusion was heterogeneously distributed throughout the LV myocardium. During hyperaemia, global MPR increased by median (IQR) 158% (144-176) with the highest increase in the right coronary artery territory (171%; P<0.02). Rest and stress segmental TPR values ranged between 0.93-1.26 and 0.99-1.13, respectively, with the lowest values detected in the inferoseptal segments. No differences in perfusion parameters were found between participants with normal epicardial arteries and participants with non-significant epicardial atheromatosis (all P>0.05). Global perfusion parameters were not associated with age or menopausal status (all P>0.05).CONCLUSIONS: This descriptive study presents data on global and regional myocardial perfusion in a cohort of healthy middle-aged women.",
keywords = "CT perfusion, myocardial perfusion reserve, non-invasive imaging, reference population, stress testing, transmural perfusion ratio, Predictive Value of Tests, Humans, Middle Aged, Asymptomatic Diseases, Feasibility Studies, Coronary Stenosis/diagnostic imaging, Adult, Female, Coronary Angiography/methods, Coronary Circulation, Myocardial Perfusion Imaging/methods, Reproducibility of Results, Computed Tomography Angiography/methods, Adenosine/administration & dosage, Multidetector Computed Tomography/methods, Blood Flow Velocity, Aged, Coronary Vessels/diagnostic imaging, Vasodilator Agents/administration & dosage, Hyperemia/physiopathology, Observer Variation",
author = "Bechsgaard, {Daria Frestad} and Ida Gustafsson and Linde, {Jesper James} and Kofoed, {Klaus Fuglsang} and Eva Prescott and Hove, {Jens Dahlgaard}",
note = "{\textcopyright} 2018 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.",
year = "2019",
month = jan,
doi = "10.1111/cpf.12542",
language = "English",
volume = "39",
pages = "65--77",
journal = "Clinical Physiology and Functional Imaging",
issn = "1475-0961",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Myocardial perfusion assessed with cardiac computed tomography in women without coronary heart disease

AU - Bechsgaard, Daria Frestad

AU - Gustafsson, Ida

AU - Linde, Jesper James

AU - Kofoed, Klaus Fuglsang

AU - Prescott, Eva

AU - Hove, Jens Dahlgaard

N1 - © 2018 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

PY - 2019/1

Y1 - 2019/1

N2 - PURPOSE: Combined coronary CT angiography and CT perfusion (CTP) is a novel, non-invasive, 'one-stop' diagnostic tool to rule out ischaemia in patients suspected for coronary artery disease (CAD). However, the normal myocardial perfusion pattern by static CTP in humans is poorly described. We aimed to investigate global and regional myocardial perfusion during rest and adenosine-induced hyperaemia in asymptomatic women without history of coronary heart disease (CHD).METHODS: Using a 320-row CT scanner with a static protocol, semi-quantitative assessment of rest and stress CTP was performed in 34 asymptomatic middle-aged women without obstructive CAD (<50% stenosis) or history of CHD, and with normal exercise stress test and left ventricular (LV) function. Using a 16-segment model, we assessed global and regional values of LV myocardial perfusion reserve (MPR) and transmural perfusion ratio (TPR).RESULTS: Mean±SD age was 56 ± 13 years. Resting and hyperaemic myocardial perfusion was heterogeneously distributed throughout the LV myocardium. During hyperaemia, global MPR increased by median (IQR) 158% (144-176) with the highest increase in the right coronary artery territory (171%; P<0.02). Rest and stress segmental TPR values ranged between 0.93-1.26 and 0.99-1.13, respectively, with the lowest values detected in the inferoseptal segments. No differences in perfusion parameters were found between participants with normal epicardial arteries and participants with non-significant epicardial atheromatosis (all P>0.05). Global perfusion parameters were not associated with age or menopausal status (all P>0.05).CONCLUSIONS: This descriptive study presents data on global and regional myocardial perfusion in a cohort of healthy middle-aged women.

AB - PURPOSE: Combined coronary CT angiography and CT perfusion (CTP) is a novel, non-invasive, 'one-stop' diagnostic tool to rule out ischaemia in patients suspected for coronary artery disease (CAD). However, the normal myocardial perfusion pattern by static CTP in humans is poorly described. We aimed to investigate global and regional myocardial perfusion during rest and adenosine-induced hyperaemia in asymptomatic women without history of coronary heart disease (CHD).METHODS: Using a 320-row CT scanner with a static protocol, semi-quantitative assessment of rest and stress CTP was performed in 34 asymptomatic middle-aged women without obstructive CAD (<50% stenosis) or history of CHD, and with normal exercise stress test and left ventricular (LV) function. Using a 16-segment model, we assessed global and regional values of LV myocardial perfusion reserve (MPR) and transmural perfusion ratio (TPR).RESULTS: Mean±SD age was 56 ± 13 years. Resting and hyperaemic myocardial perfusion was heterogeneously distributed throughout the LV myocardium. During hyperaemia, global MPR increased by median (IQR) 158% (144-176) with the highest increase in the right coronary artery territory (171%; P<0.02). Rest and stress segmental TPR values ranged between 0.93-1.26 and 0.99-1.13, respectively, with the lowest values detected in the inferoseptal segments. No differences in perfusion parameters were found between participants with normal epicardial arteries and participants with non-significant epicardial atheromatosis (all P>0.05). Global perfusion parameters were not associated with age or menopausal status (all P>0.05).CONCLUSIONS: This descriptive study presents data on global and regional myocardial perfusion in a cohort of healthy middle-aged women.

KW - CT perfusion

KW - myocardial perfusion reserve

KW - non-invasive imaging

KW - reference population

KW - stress testing

KW - transmural perfusion ratio

KW - Predictive Value of Tests

KW - Humans

KW - Middle Aged

KW - Asymptomatic Diseases

KW - Feasibility Studies

KW - Coronary Stenosis/diagnostic imaging

KW - Adult

KW - Female

KW - Coronary Angiography/methods

KW - Coronary Circulation

KW - Myocardial Perfusion Imaging/methods

KW - Reproducibility of Results

KW - Computed Tomography Angiography/methods

KW - Adenosine/administration & dosage

KW - Multidetector Computed Tomography/methods

KW - Blood Flow Velocity

KW - Aged

KW - Coronary Vessels/diagnostic imaging

KW - Vasodilator Agents/administration & dosage

KW - Hyperemia/physiopathology

KW - Observer Variation

UR - http://www.scopus.com/inward/record.url?scp=85054168983&partnerID=8YFLogxK

U2 - 10.1111/cpf.12542

DO - 10.1111/cpf.12542

M3 - Journal article

C2 - 30270499

VL - 39

SP - 65

EP - 77

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

SN - 1475-0961

IS - 1

ER -

ID: 55376096