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Myocardial perfusion assessed with cardiac computed tomography in women without coronary heart disease
Author(s) -
Bechsgaard Daria Frestad,
Gustafsson Ida,
Linde Jesper James,
Kofoed Klaus Fuglsang,
Prescott Eva,
Hove Jens Dahlgaard
Publication year - 2019
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/cpf.12542
Subject(s) - medicine , hyperaemia , cardiology , perfusion , asymptomatic , coronary artery disease , myocardial perfusion imaging , perfusion scanning , stenosis , radiology , blood flow
Summary Purpose Combined coronary CT angiography and CT perfusion (CTP) is a novel, non‐invasive, ‘one‐stop’ diagnostic tool to rule out ischaemia in patients suspected for coronary artery disease (CAD). However, the normal myocardial perfusion pattern by static CTP in humans is poorly described. We aimed to investigate global and regional myocardial perfusion during rest and adenosine‐induced hyperaemia in asymptomatic women without history of coronary heart disease (CHD). Methods Using a 320‐row CT scanner with a static protocol, semi‐quantitative assessment of rest and stress CTP was performed in 34 asymptomatic middle‐aged women without obstructive CAD (<50% stenosis) or history of CHD, and with normal exercise stress test and left ventricular (LV) function. Using a 16‐segment model, we assessed global and regional values of LV myocardial perfusion reserve (MPR) and transmural perfusion ratio (TPR). Results Mean±SD age was 56 ± 13 years. Resting and hyperaemic myocardial perfusion was heterogeneously distributed throughout the LV myocardium. During hyperaemia, global MPR increased by median (IQR) 158% (144–176) with the highest increase in the right coronary artery territory (171%; P <0.02). Rest and stress segmental TPR values ranged between 0.93‐1.26 and 0.99‐1.13, respectively, with the lowest values detected in the inferoseptal segments. No differences in perfusion parameters were found between participants with normal epicardial arteries and participants with non‐significant epicardial atheromatosis (all P >0.05). Global perfusion parameters were not associated with age or menopausal status (all P >0.05). Conclusions This descriptive study presents data on global and regional myocardial perfusion in a cohort of healthy middle‐aged women.