title: Estimation of coronary flow reserve by Tc-99m sestamibi imaging in patients with coronary artery disease: comparison with the results of intracoronary Doppler technique.
abstract: BACKGROUND
  This study compared coronary flow reserve (CFR) estimated by technetium 99m sestamibi imaging with the results obtained with intracoronary Doppler in patients with coronary artery disease. Intraobserver and interobserver reproducibility of the radionuclide-estimated CFR was also assessed.
  
  
  RESULTS
  Fourteen consecutive patients (mean age, 54 +/- 7 years) with documented coronary artery disease in whom percutaneous coronary intervention was planned underwent dipyridamole (0.74 mg/kg) sestamibi imaging and intracoronary Doppler within 5 days. Myocardial blood flow (MBF) was estimated by measurement of first transit counts in the pulmonary artery and myocardial counts from single photon emission computed tomography images. Estimated CFR was expressed as the ratio of stress MBF to rest MBF. In the study vessels, CFR was 1.36 +/- 0.43 as estimated by sestamibi and 1.39 +/- 0.42 by intracoronary Doppler ( P = .69). A significant relationship between CFR estimated by sestamibi and CFR obtained by intracoronary Doppler was observed ( r = 0.85, P < .001). On Bland-Altman analysis, the mean difference between CFR by sestamibi and by Doppler was 0.03 and the intraclass correlation coefficients for intraobserver and interobserver reproducibility were high (all P < .001) for both global and regional CFR.
  
  
  CONCLUSIONS
  This study demonstrates a good agreement between CFR estimated by sestamibi imaging and by intracoronary Doppler results and a lack of intraobserver and interobserver variability of this noninvasive approach.
authors.affiliation: Department of Biomorphological Sciences, University Federico II, Via Pansini 5, 80131 Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Storto
authors.forename: Plinio
authors.initials: P
authors.lastname: Cirillo
authors.forename: Maria Lucia Eufrasia
authors.initials: ML
authors.lastname: Vicario
authors.forename: Teresa
authors.initials: T
authors.lastname: Pellegrino
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Sorrentino
authors.forename: Mario
authors.initials: M
authors.lastname: Petretta
authors.forename: Gennaro
authors.initials: G
authors.lastname: Galasso
authors.forename: Valerio
authors.initials: V
authors.lastname: De Sanctis
authors.forename: Federico
authors.initials: F
authors.lastname: Piscione
authors.forename: Alberto
authors.initials: A
authors.lastname: Cuocolo
mesh_terms: D000465:Algorithms; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods