Correlation between thallium-201 myocardial perfusion defects and the functional severity of coronary artery stenosis as assessed by pressure-derived myocardial fractional flow reserve.
Although a relationship between the coronary pressure-derived fractional flow reserve (FFR) and the presence of myocardial ischemia as demonstrated by radionuclide imaging has been reported in a select group of patients, it remains to be established whether this relation also holds true in actual clinical settings with a heterogeneous group of patients. Accordingly, 194 coronary vessels and their supply territories were evaluated in 165 consecutive patients with suspected or known coronary artery disease. An FFR <0.75, which is regarded as indicative of functionally important stenosis, showed a significant correlation with the redistribution of (201)Tl (p<0.0001), with a sensitivity of 79% and specificity of 73%. In 70 infarct-related coronary arteries, the sensitivity and specificity were 79% and 75%, respectively, whereas in the 124 remaining vessels that were not related to the myocardial infarct, the sensitivity and specificity were 80% and 72%, respectively. In addition, the FFR exhibited a significant inverse correlation with the (201)Tl reversibility score (r=-0.62; p<0.0001). These results suggest that the FFR has a significant relationship with scintigraphic evidence of myocardial ischemia and can be regarded as a marker of its presence or absence in patients in actual clinical settings.
Yanagisawa
Hidefumi
H
Department of Internal Medicine II, Tokyo Medical University, Japan. yanagi@tokyo-med.ac.jp
Chikamori
Taishiro
T
Tanaka
Nobuhiro
N
Hatano
Tsuguhisa
T
Morishima
Takayuki
T
Hida
Satoshi
S
Iino
Hitoshi
H
Amaya
Kazutaka
K
Takazawa
Kenji
K
Yamashina
Akira
A
D000368:Aged; D001794:Blood Pressure; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D023921:Coronary Stenosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes