title: Relationships between left ventricular asynchrony and myocardial blood flow.
abstract: 82Rb PET protocols enable determination of left ventricular asynchrony (LVAS) at rest and stress, along with myocardial blood flow (MBF). We hypothesized that in patients with resting LVAS, MBF differs between those with stress-induced LVAS improvement and those with stress-induced LVAS deterioration.
  
  
  
  We retrospectively analyzed82Rb rest/regadenoson stress PET studies of 195 patients evaluated for known or suspected coronary artery disease. MBF was computed from first-pass data; function and relative perfusion were computed from myocardial equilibrium data. LVAS was defined as phase contraction bandwidth (BW) above82Rb gender-specific normal limits, with changes defined as BW moving into or out of normal ranges.
  
  
  
  Among the 195 patients, 64 had LVAS at rest, of whom 13 reverted to normal and 51 continued to have LVAS with stress. Patients who did not improve had lower stress MBF (1.04 ± 0.69 vs 1.58 ± 0.67, p = .02) and coronary flow reserve (1.94 ± 1.16 vs 3.04 ± 1.22, p = .01) than those who did improve. ROC analysis indicated that the parameter most strongly associated with improvement in asynchrony for patients with resting LVAS was reduction in MBF heterogeneity (ROC area (accuracy) = 84%, sensitivity = 92%, and specificity = 67%).
  
  
  
  LVAS is highly correlated with MBF and CVR, with stress-induced improvement in synchronicity most strongly associated with improved MBF homogeneity.
authors.affiliation: Research Department, St. Francis Hospital, Roslyn, NY, USA. Andrew.Vantosh@chsli.org.|Division of Cardiovascular Research, St. Francis Hospital - The Heart Center, 100 Port Washington Boulevard, Roslyn, NY, 11576, USA. Andrew.Vantosh@chsli.org.
authors.forename: Andrew
authors.initials: A
authors.lastname: Van Tosh
authors.affiliation: Department of Radiology, Emory University, Atlanta, GA, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Votaw
authors.affiliation: Department of Radiology, Emory University, Atlanta, GA, USA.
authors.forename: C David
authors.initials: CD
authors.lastname: Cooke
authors.affiliation: Research Department, St. Francis Hospital, Roslyn, NY, USA.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Reichek
authors.affiliation: Division of Nuclear Medicine and Molecular Imaging, North Shore - Long Island Jewish Health System, Manhasset & New Hyde Park, NY, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Palestro
authors.affiliation: Division of Nuclear Medicine and Molecular Imaging, North Shore - Long Island Jewish Health System, Manhasset & New Hyde Park, NY, USA.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Nichols
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D003326:Coronary Circulation; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012413:Rubidium; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014655:Vascular Resistance; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: D019275:Radiopharmaceuticals; D012413:Rubidium
keywords: PET/CT; asynchrony; coronary flow reserve; rubidium isotopes