OBJECTIVES: The purpose of this study was to quantify the effects of coronary atherosclerosis morphology and extent on myocardial flow reserve (MFR). BACKGROUND: Although the relationship between coronary stenosis and myocardial perfusion is well established, little is known about the contribution of other anatomic descriptors of atherosclerosis burden to this relationship. METHODS: We evaluated the relationship between atherosclerosis plaque burden, morphology, and composition and regional MFR (MFR(regional)) in 73 consecutive patients undergoing Rubidium-82 positron emission tomography and coronary computed tomography angiography for the evaluation of known or suspected coronary artery disease. RESULTS: Atherosclerosis was seen in 51 of 73 patients and in 107 of 209 assessable coronary arteries. On a per-vessel basis, the percentage diameter stenosis (p = 0.02) or summed stenosis score (p = 0.002), integrating stenoses in series, was the best predictor of MFR(regional). Importantly, MFR(regional) varied widely within each coronary stenosis category, even in vessels with nonobstructive plaques (n = 169), 38% of which had abnormal MFR(regional) (<2.0). Total plaque length, composition, and remodeling index were not associated with lower MFR. On a per-patient basis, the modified Duke CAD (coronary artery disease) index (p = 0.04) and the number of segments with mixed plaque (p = 0.01) were the best predictors of low MFR(global). CONCLUSIONS: Computed tomography angiography descriptors of atherosclerosis had only a modest effect on downstream MFR. On a per-patient basis, the extent and severity of atherosclerosis as assessed by the modified Duke CAD index and the number of coronary segments with mixed plaque were associated with decreased MFR.
OBJECTIVES: The purpose of this study was to quantify the effects of coronary atherosclerosis morphology and extent on myocardial flow reserve (MFR). BACKGROUND: Although the relationship between coronary stenosis and myocardial perfusion is well established, little is known about the contribution of other anatomic descriptors of atherosclerosis burden to this relationship. METHODS: We evaluated the relationship between atherosclerosis plaque burden, morphology, and composition and regionalMFR (MFR(regional)) in 73 consecutive patients undergoing Rubidium-82 positron emission tomography and coronary computed tomography angiography for the evaluation of known or suspected coronary artery disease. RESULTS:Atherosclerosis was seen in 51 of 73 patients and in 107 of 209 assessable coronary arteries. On a per-vessel basis, the percentage diameter stenosis (p = 0.02) or summed stenosis score (p = 0.002), integrating stenoses in series, was the best predictor of MFR(regional). Importantly, MFR(regional) varied widely within each coronary stenosis category, even in vessels with nonobstructive plaques (n = 169), 38% of which had abnormal MFR(regional) (<2.0). Total plaque length, composition, and remodeling index were not associated with lower MFR. On a per-patient basis, the modified Duke CAD (coronary artery disease) index (p = 0.04) and the number of segments with mixed plaque (p = 0.01) were the best predictors of low MFR(global). CONCLUSIONS: Computed tomography angiography descriptors of atherosclerosis had only a modest effect on downstream MFR. On a per-patient basis, the extent and severity of atherosclerosis as assessed by the modified Duke CAD index and the number of coronary segments with mixed plaque were associated with decreased MFR.
Authors: Thomas H Schindler; Alvaro D Facta; John O Prior; Roxana Campisi; Masayuki Inubushi; Michael C Kreissl; Xiao-Li Zhang; James Sayre; Magnus Dahlbom; Heinrich R Schelbert Journal: Eur J Nucl Med Mol Imaging Date: 2006-04-26 Impact factor: 9.236
Authors: K L Gould; Y Nakagawa; K Nakagawa; S Sdringola; M J Hess; M Haynie; N Parker; N Mullani; R Kirkeeide Journal: Circulation Date: 2000-04-25 Impact factor: 29.690
Authors: M Di Carli; J Czernin; C K Hoh; V H Gerbaudo; R C Brunken; S C Huang; M E Phelps; H R Schelbert Journal: Circulation Date: 1995-04-01 Impact factor: 29.690
Authors: Satyendra Giri; Leslee J Shaw; Dakshina R Murthy; Mark I Travin; D Douglas Miller; Rory Hachamovitch; Salvadore Borges-Neto; Daniel S Berman; David D Waters; Gary V Heller Journal: Circulation Date: 2002-01-01 Impact factor: 29.690
Authors: B De Bruyne; F Hersbach; N H Pijls; J Bartunek; J W Bech; G R Heyndrickx; K L Gould; W Wijns Journal: Circulation Date: 2001-11-13 Impact factor: 29.690
Authors: K Egashira; T Inou; Y Hirooka; A Yamada; Y Maruoka; H Kai; M Sugimachi; S Suzuki; A Takeshita Journal: J Clin Invest Date: 1993-01 Impact factor: 14.808
Authors: R Parkash; R A deKemp; T D Ruddy; A Kitsikis; R Hart; L Beauchesne; L Beauschene; Kathryn Williams; R A Davies; M Labinaz; R S B Beanlands Journal: J Nucl Cardiol Date: 2004 Jul-Aug Impact factor: 5.952
Authors: Lauren A Baldassarre; Subha V Raman; James K Min; Jennifer H Mieres; Martha Gulati; Nanette K Wenger; Thomas H Marwick; Chiara Bucciarelli-Ducci; C Noel Bairey Merz; Dipti Itchhaporia; Keith C Ferdinand; Carl J Pepine; Mary Norine Walsh; Jagat Narula; Leslee J Shaw Journal: JACC Cardiovasc Imaging Date: 2016-04
Authors: Masanao Naya; Venkatesh L Murthy; Viviany R Taqueti; Courtney R Foster; Josh Klein; Mariya Garber; Sharmila Dorbala; Jon Hainer; Ron Blankstein; Frederick Resnic; Marcelo F Di Carli Journal: J Nucl Med Date: 2014-01-09 Impact factor: 10.057
Authors: Masanao Naya; Venkatesh L Murthy; Courtney R Foster; Mariya Gaber; Josh Klein; Jon Hainer; Sharmila Dorbala; Ron Blankstein; Marcelo F Di Carli Journal: J Am Coll Cardiol Date: 2013-03-21 Impact factor: 24.094