Assessment of coronary artery disease severity by positron emission tomography. Comparison with quantitative arteriography in 193 patients

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Circulation. 1989;79:825-835

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ARTICLES

Assessment of coronary artery disease severity by positron emission tomography. Comparison with quantitative arteriography in 193 patients

LL Demer, KL Gould, RA Goldstein, RL Kirkeeide, NA Mullani, RW Smalling, A Nishikawa and ME Merhige
Department of Medicine, University of Texas Medical School, Houston 77225.

To assess the accuracy of positron emission tomography (PET) for evaluation of coronary artery disease (CAD), cardiac PET perfusion images were obtained at rest and with dipyridamole-handgrip stress in 193 patients undergoing coronary arteriography. PET images were reviewed by two independent readers blinded to clinical data. Subjective defect severity scores were assigned to each myocardial region on a 0 (normal) to 5 (severe) scale. Results were compared with arteriographic stenosis severity expressed as stenosis flow reserve (SFR), with continuous values ranging from 0 (total occlusion) to 5 (normal), calculated from quantitative arteriographic dimensions using automated detection of the vessel borders. There were 115 patients with significant CAD (SFR less than 3), 37 patients with mild CAD (3 less than or equal to SFR less than 4), and 41 patients with essentially normal coronaries (SFR greater than or equal to 4). With increasingly severe impairment of stenosis flow reserve, subjective PET defect severity increased. Despite wide scatter, a PET score of 2 or more was highly predictive of significant flow reserve impairment (SFR less than 3). For each patient, the score of the most severe PET defect correlated with the SFR of that patient's most severe stenosis (rs = 0.77 +/- 0.06). For each of 243 stenoses, PET defect score correlated with the SFR of the corresponding artery (rs = 0.63 +/- 0.08). PET defect location closely matched the region supplied by the diseased artery, and readers agreed whether the most severe PET defect was less than or more than 2 for 89% of patients.

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				R Montisci, A Vacca, P Garau, P Colonna, M Ruscazio, G Passiu, S Iliceto, and A Mathieu Detection of early impairment of coronary flow reserve in patients with systemic sclerosis Ann Rheum Dis, September 1, 2003; 62(9): 890 - 893. [Abstract] [Full Text] [PDF]

				E. Nagel, C. Klein, I. Paetsch, S. Hettwer, B. Schnackenburg, K. Wegscheider, and E. Fleck Magnetic Resonance Perfusion Measurements for the Noninvasive Detection of Coronary Artery Disease Circulation, July 29, 2003; 108(4): 432 - 437. [Abstract] [Full Text] [PDF]

				S. Sdringola, K. Nakagawa, Y. Nakagawa, S. W. Yusuf, F. Boccalandro, N. Mullani, M. Haynie, M. J. Hess, and K. L. Gould Combined intense lifestyle and pharmacologic lipid treatment further reduce coronary events and myocardial perfusion abnormalities compared with usual-care cholesterol-lowering drugs in coronary artery disease J. Am. Coll. Cardiol., January 15, 2003; 41(2): 263 - 272. [Abstract] [Full Text] [PDF]

				M. Daimon, H. Watanabe, H. Yamagishi, T. Muro, K. Akioka, K. Hirata, K. Takeuchi, and J. Yoshikawa Physiologic assessment of coronary artery stenosis by coronary flow reserve measurements with transthoracic doppler echocardiography: comparison with exercise thallium-201 single-photon emission computed tomography J. Am. Coll. Cardiol., April 1, 2001; 37(5): 1310 - 1315. [Abstract] [Full Text] [PDF]

				S. Sdringola, D. Patel, and K. L. Gould High Prevalence of Myocardial Perfusion Abnormalities on Positron Emission Tomography in Asymptomatic Persons With a Parent or Sibling With Coronary Artery Disease Circulation, January 30, 2001; 103(4): 496 - 501. [Abstract] [Full Text] [PDF]

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