[Value of absolute quantification of myocardial perfusion by PET in detecting coronary microvascular disease in patients with non-obstructive coronaries].

Ping Wu, Xiaoshan Guo, Xi Zhang, Zhifang Wu, Ruonan Wang, Li Li, M. Liang, Hongliang Wang, M. Yan, ZhiXing Qin, P. Cheng, C. Jin, Min-Fu Yang, Yuetao Wang, Sijin Li
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Abstract

Objective To compare the incidence of coronary microvascular disease (CMVD) between patients with non-obstructive and obstructive coronary arteries. Methods We retrospectively analyzed 97 patients with angina pectoris, who underwent the absolute quantitative PET examination of myocardial perfusion and coronary anatomy examination within 90 days. All patients were divided into two groups: non-obstructive group (72 cases, no stenosis ≥50% in all three coronary arteries) and obstructive group (25 cases, at least one coronary stenosis ≥50%; and at least one coronary stenosis<50%). Quantitative parameters derived from PET including rest myocardial blood flow (RMBF), stress myocardial blood flow (SMBF), coronary flow reserve (CFR) and cardiovascular risk factors were compared between the two groups. CMVD was defined as CFR<2.90 and SMBF<2.17 ml·min-1·g-1. Results Incidence of CMVD was significant higher in the non-obstructive coronary arteries of the obstructive group than in the non-obstructive coronary arteries of non-obstructive group (47.1% (16/34) vs. 25.5% (55/216), χ2=6.738, P=0.009) while incidence of CMVD was similar between non-obstructive and obstructive patients ((44% (11/25) vs. 33.3% (24/72), χ2=0.915, P=0.339). RMBF ((0.83±0.14) ml·min-1·g-1 vs. (0.82±0.17) ml·min-1·g-1), SMBF ((2.13±0.60) ml·min-1·g-1 vs. (1.91±0.50) ml·min-1·g-1) and CFR (2.59±0.66 vs. 2.36±0.47) were similar between the two groups (all P>0.05). Conclusions CMVD can occur in non-obstructive coronary arteries in both patients with non-occlusive coronary arteries and patients with obstructive coronary arteries. Prevalence of CMVD is significantly higher in patients with obstructive coronary arteries than in patients with non-obstructive coronary arteries. The CMVD severity is similar between the two groups. Key words: Positron-emission tomography; Coronary artery disease; Coronary flow reserve; Microcirculation
【PET绝对定量心肌灌注在非阻塞性冠状动脉患者冠状动脉微血管病变中的价值】。
目的比较非阻塞性和阻塞性冠状动脉患者冠状动脉微血管病变(CMVD)的发生率。方法回顾性分析97例心绞痛患者在90天内行心肌灌注绝对定量PET检查和冠状动脉解剖检查。所有患者分为两组:非阻塞性组(72例,3条冠状动脉均无狭窄≥50%)和阻塞性组(25例,至少1条冠状动脉狭窄≥50%;至少一例冠状动脉狭窄(0.05)。结论非阻塞性冠状动脉和阻塞性冠状动脉均可发生CMVD。阻塞性冠状动脉患者CMVD的患病率明显高于非阻塞性冠状动脉患者。两组的CMVD严重程度相似。关键词:正电子发射断层扫描;冠状动脉疾病;冠状动脉血流储备;微循环
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