Open AccessComputed Tomography Myocardial Perfusion Imaging With Transesophageal Atrial Pacing Stress Test in Patients With Borderline Stenoses in the Coronary Arteries: a Comparison With Fractional Flow Reserve
Author(s) -
Y. A. Omarov,
Т. Н. Веселова,
Р. М. Шахнович,
Т. С. Сухинина,
Н. С. Жукова,
И. Н. Меркулова,
Д. В. Певзнер,
G. K. Arutunyan,
В. М. Миронов,
Е. В. Меркулов,
А. Н. Самко,
S.K. Ternovoy,
I I Staroverov
Publication year - 2021
Publication title -
kardiologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.159
H-Index - 16
eISSN - 2412-5660
pISSN - 0022-9040
DOI - 10.18087/cardio.2021.1.n1343
Subject(s) - medicine , fractional flow reserve , perfusion , cardiology , coronary arteries , stenosis , hemodynamics , myocardial perfusion imaging , computed tomography angiography , perfusion scanning , ischemia , radiology , angiography , stress echocardiography , coronary artery disease , coronary angiography , artery , myocardial infarction
Aim To evaluate the diagnostic accuracy of cardiac perfusion computed tomography (PCT) with transesophageal electrocardiostimulation (TE ECS) for detection of ischemia in patients with borderline coronary stenosis (50–75 %) compared to measurements of fractional flow reserve (FFR). Material and methods The study included 25 patients with borderline (50–75 %) coronary stenosis as per data of computed tomography angiography (CTA) or coronary angiography (CAG). Later the patients underwent invasive measurement of FFR and cardiac PCT on a 320-row detector tomograph in combination with the TE ECS stress test. FFR values <0.8 indicated the hemodynamic significance of stenosis. Myocardial perfusion was evaluated visually based on consensus of two experts. Results All patients completed the study protocol. Cardiac pacing duration was 6 min for all patients. Four patients required intravenous administration of atropine sulphate. PCT with TE ECS detected significant for FFR stenoses with sensitivity, specificity, and predictive value of a positive result and predictive value for a negative result of 47, 90, 87, and 53 %, respectively. Conclusion PCT with TE ECS in combination with CTA can be considered as an informative method for simultaneous evaluation of the condition of coronary arteries and detection of myocardial ischemia. This method is particularly relevant for assessing the hemodynamic significance of borderline coronary stenoses.