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

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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.

Original languageEnglish
JournalClinical Physiology and Functional Imaging
Volume39
Issue number1
Pages (from-to)65-77
Number of pages13
ISSN1475-0961
DOIs
Publication statusPublished - Jan 2019

    Research areas

  • 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

ID: 55376096