Literature DB >> 34249657

Clinical and imaging predictors of impaired myocardial perfusion in symptomatic patients after percutaneous coronary intervention: insights from dynamic CT myocardial perfusion imaging.

Haiyan Ma1,2, Xu Dai1, Xiaojun Yang3, Xihui Zhao2, Rongpin Wang2, Jiayin Zhang4.   

Abstract

BACKGROUND: We aimed to investigate the relationship between baseline clinical characteristics and postprocedural myocardial perfusion as determined by dynamic computed tomography myocardial perfusion imaging (CT-MPI).
METHODS: We retrospectively included consecutive symptomatic post percutaneous coronary intervention (PCI) patients, who underwent dynamic CT-MPI + coronary CT angiography (CCTA) and who were revealed to have patent stents on previously revascularized lesions. Myocardial blood flow (MBF) was measured for stented territories and reference territories. Various baseline clinical and angiographic parameters were tested for the association with reduced MBF of stented territories.
RESULTS: A total of 81 patients with 96 stented vessels were included in the analysis. The mean effective doses of radiation for the whole integrated CT protocol (calcium score + dynamic CT-MPI + CCTA) was 4.89±1.14 (2.58-6.93) mSv. Overall, 49 stented vessels had reduced MBF (75.3±17.2 mL/100 mL/min) within related territories, whereas 47 stented vessels had normal MBF (138.6±20.5 mL/100 mL/min). Peak levels of high-sensitivity cardiac troponin I (hs-cTnI), N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), high-sensitivity C-reactive protein (hs-CRP), and glucose were significantly higher, while preprocedural thrombolysis in myocardial infarction (TIMI) flow grade was lower in participants with reduced MBF of stented territories. Acute myocardial infarction (AMI) also predominantly presented in participants with decreased MBF after revascularization. According to multivariate analysis, peak hs-cTnI level was the strongest predictor [adjusted hazard ratio (HR): 4.548, P=0.003] for decreased myocardial perfusion, followed by TIMI flow grade, AMI, stenotic extent, and NT-pro-BNP.
CONCLUSIONS: The baseline hs-cTnI peak level was the strongest predictor for decreased myocardial perfusion after revascularization, followed by AMI, stenotic extent, and NT-pro-BNP. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.

Entities:  

Keywords:  Coronary artery disease (CAD); computed tomography (CT); myocardial blood flow (MBF); myocardial perfusion imaging (MPI); percutaneous coronary intervention (PCI)

Year:  2021        PMID: 34249657      PMCID: PMC8250036          DOI: 10.21037/qims-20-977

Source DB:  PubMed          Journal:  Quant Imaging Med Surg        ISSN: 2223-4306


  21 in total

Review 1.  Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association.

Authors:  Manuel D Cerqueira; Neil J Weissman; Vasken Dilsizian; Alice K Jacobs; Sanjiv Kaul; Warren K Laskey; Dudley J Pennell; John A Rumberger; Thomas Ryan; Mario S Verani
Journal:  Circulation       Date:  2002-01-29       Impact factor: 29.690

Review 2.  New frontiers in cardiology: drug-eluting stents: Part II.

Authors:  J Eduardo Sousa; Patrick W Serruys; Marco A Costa
Journal:  Circulation       Date:  2003-05-13       Impact factor: 29.690

3.  Accuracy of Myocardial Blood Flow Estimation From Dynamic Contrast-Enhanced Cardiac CT Compared With PET.

Authors:  Adam M Alessio; Michael Bindschadler; Janet M Busey; William P Shuman; James H Caldwell; Kelley R Branch
Journal:  Circ Cardiovasc Imaging       Date:  2019-06-14       Impact factor: 7.792

Review 4.  Prevention and treatment of microvascular obstruction-related myocardial injury and coronary no-reflow following percutaneous coronary intervention: a systematic approach.

Authors:  Ronen Jaffe; Alexander Dick; Bradley H Strauss
Journal:  JACC Cardiovasc Interv       Date:  2010-07       Impact factor: 11.195

5.  Detection of Hemodynamically Significant Coronary Stenosis: CT Myocardial Perfusion versus Machine Learning CT Fractional Flow Reserve.

Authors:  Yuehua Li; Mengmeng Yu; Xu Dai; Zhigang Lu; Chengxing Shen; Yining Wang; Bin Lu; Jiayin Zhang
Journal:  Radiology       Date:  2019-09-24       Impact factor: 11.105

6.  Third generation dual-source CT enables accurate diagnosis of coronary restenosis in all size stents with low radiation dose and preserved image quality.

Authors:  Yuehua Li; Mengmeng Yu; Wenbin Li; Zhigang Lu; Meng Wei; Jiayin Zhang
Journal:  Eur Radiol       Date:  2018-01-18       Impact factor: 5.315

7.  Impact of Specific Crossing Techniques in Chronic Total Occlusion Percutaneous Coronary Intervention on Recovery of Absolute Myocardial Perfusion.

Authors:  Stefan P Schumacher; Wijnand J Stuijfzand; Roel S Driessen; Pepijn A van Diemen; Michiel J Bom; Henk Everaars; Marly Kockx; Pieter G Raijmakers; Ronald Boellaard; Peter M van de Ven; Albert C van Rossum; Maksymilian P Opolski; Alexander Nap; Paul Knaapen
Journal:  Circ Cardiovasc Interv       Date:  2019-11-01       Impact factor: 6.546

8.  Utility of cardiac biomarkers in predicting infarct size, left ventricular function, and clinical outcome after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Authors:  Stanley Chia; Fred Senatore; O Christopher Raffel; Hang Lee; Frans J Th Wackers; Ik-Kyung Jang
Journal:  JACC Cardiovasc Interv       Date:  2008-08       Impact factor: 11.195

9.  Prevalence of Decreased Myocardial Blood Flow in Symptomatic Patients with Patent Coronary Stents: Insights from Low-Dose Dynamic CT Myocardial Perfusion Imaging.

Authors:  Yuehua Li; Mingyuan Yuan; Mengmeng Yu; Zhigang Lu; Chengxing Shen; Yining Wang; Bin Lu; Jiayin Zhang
Journal:  Korean J Radiol       Date:  2019-04       Impact factor: 3.500

10.  Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction.

Authors:  Jingwei Pan; Mingyuan Yuan; Mengmeng Yu; Yajie Gao; Chengxing Shen; Yining Wang; Bin Lu; Jiayin Zhang
Journal:  Korean J Radiol       Date:  2019-05       Impact factor: 3.500

View more
  3 in total

1.  Predictive value of the echocardiographic noninvasive myocardial work index for left ventricular reverse remodeling in patients with multivessel coronary artery disease after percutaneous coronary intervention.

Authors:  Qiang Zheng; Lin Liu; Yuanyuan Liu; Cunying Cui; Yanan Li; Ying Wang; Yanbin Hu; Minfu Bai; Danqing Huang
Journal:  Quant Imaging Med Surg       Date:  2022-07

2.  The use of lesion-specific calcium morphology to guide the appropriate use of dynamic CT myocardial perfusion imaging and CT fractional flow reserve.

Authors:  Xu Dai; Zhigang Lu; Yarong Yu; Lihua Yu; Hao Xu; Jiayin Zhang
Journal:  Quant Imaging Med Surg       Date:  2022-02

3.  Predictive value of thrombolysis in myocardial infarction frame count for coronary microvascular dysfunction evaluated with an angiography-derived index of microcirculatory resistance in patients with coronary slow flow.

Authors:  Menghuan Li; Hu Su; Ming Jiang; Zhi Zuo; Zhenyang Su; Lijun Hao; Jiaming Yang; Zhiyong Zhang; Hui Wang; Xiangqing Kong
Journal:  Quant Imaging Med Surg       Date:  2022-10
  3 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.