open access

https://hdl.handle.net/2115/80092

Improved regionalmyocardial blood flow and flow reserve after coronary revascularization as assessed by serial O-15-water positron emission tomography/computed tomography

英語

O-15-water positron emission tomography

2020-01

Oxford University Press

European heart journal cardiovascular Imaging

21(1)

36-46

Aims Myocardial perfusion imaging without and with quantitative myocardial blood flow (MBF) and myocardial flow reserve (MFR) plays an important role in the diagnosis and risk stratification of patients with stable coronary artery disease (CAD). We aimed to quantify the effects of coronary revascularization on regional stress MBF and MFR and to determine whether the presence of subendocardial infarction was associated with these changes. Methods and results Forty-seven patients with stable CAD were prospectively enrolled. They underwent 15O-water positron emission tomography at baseline and 6 months after optimal medical therapy alone (n = 16), percutaneous coronary intervention (PCI) (n = 18), or coronary artery bypass grafting (CABG) (n = 13). Stenosis of >= 50% diameter was detected in 98/141 vessels (70%). The regional MFR was significantly increased from baseline to follow-up [1.84 (interquartile range, IQR 1.28-2.17) vs. 2.12 (IQR 1.69-2.63), P < 0.001] in vessel territories following PCI or CABG due to an increase in the stress MBF [1.33 (IQR 0.97-1.67) mL/g/min vs. 1.64 (IQR 1.38-2.17) mL/g/min, P < 0.001], whereas there was no significant change in the regional stress MBF or MFR in vessel territories without revascularization. A multilevel mixed-effects models adjusted for baseline characteristics, subendocardial infarction assessed by cardiovascular magnetic resonance imaging, and intra-patient correlation showed that the degree of angiographic improvement after coronary revascularization was significantly associated with increased regional stress MBF and MFR (P < 0.05 for all). Conclusion Coronary revascularization improved the regional stress MBF and MFR in patients with stable CAD. The magnitude of these changes was associated with the extent of revascularization independent of subendocardial infarction.

学術雑誌論文

Accepted Manuscript

This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal, Cardiovascular Imaging following peer review. The version of record Tadao Aikawa, Masanao Naya, Kazuhiro Koyanagawa, Osamu Manabe, Masahiko Obara, Keiichi Magota, Noriko Oyama-Manabe, Nagara Tamaki, Toshihisa Anzai, Improved regional myocardial blood flow and flow reserve after coronary revascularization as assessed by serial 15O-water positron emission tomography/computed tomography, European Heart Journal - Cardiovascular Imaging, Volume 21, Issue 1, January 2020, Pages 36-46, is available online at: https://doi.org/10.1093/ehjci/jez220

2047-2404