Assessment of coronary flow reserve by sestamibi imaging in patients with typical chest pain and normal coronary arteries

Giovanni Storto, Anna Rita Sorrentino, Teresa Pellegrino, Raffaele Liuzzi, Mario Petretta, Alberto Cuocolo

Research output: Contribution to journalArticle

Abstract

Purpose: We assessed coronary flow reserve (CFR) by sestamibi imaging in patients with typical chest pain, positive exercise stress test and normal coronary vessels. Methods: Thirty-five patients with typical chest pain and normal angiogram and 12 control subjects with atypical chest pain underwent dipyridamole/rest 99mTc-sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first transit counts in the pulmonary artery and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of stress to rest MBF. Rest MBF and CFR were corrected for rate-pressure product (RPP) and expressed as normalised MBF (MBFn) and normalised CFR (CFRn). Coronary vascular resistances (CVR) were calculated as the ratio between mean arterial pressure and estimated MBF. Results: At rest, estimated MBF and MBFn were lower in controls than in patients (0.98 ± 0.4 vs 1.30 ± 0.3 counts/pixel/s and 1.14 ± 0.5 vs 1.64 ± 0.6 counts/pixel/s, respectively, both p <0.02). Stress MBF was not different between controls and patients (2.34 ± 0.8 vs 2.01 ± 0.7 counts/pixel/s, p=NS). Estimated CFR was 2.40 ± 0.3 in controls and 1.54 ± 0.3 in patients (p <0.0001). After correction for the RPP, CFRn was still higher in controls than in patients (2.1 ± 0.5 vs 1.29 ± 0.5, p <0.0001). At baseline, CVR values were lower (p <0.01) in patients than in controls. Dipyridamole-induced changes in CVR were greater (p <0.0001) in controls (-63%) than in patients (-35%). In the overall study population, a significant correlation between dipyridamole-induced changes in CVR and CFR was observed (r = -0.88, p <0.0001). Conclusion: SPECT might represent a useful non-invasive method for assessing coronary vascular function in patients with angina and a normal coronary angiogram.

Original languageEnglish
Pages (from-to)1156-1161
Number of pages6
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume34
Issue number8
DOIs
Publication statusPublished - Aug 2007

Keywords

  • Chest pain
  • Coronary flow reserve
  • SPECT imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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