https://scholars.lib.ntu.edu.tw/handle/123456789/471020
標題: | PET assessment of myocardial perfusion reserve inversely correlates with intravascular ultrasound findings in angiographically normal cardiac transplant recipients | 作者: | YEN-WEN WU YING-HSIEN CHEN SHOEI-SHEN WANG Jui H.-Y. RUOH-FANG YEN KAI-YUAN TZEN MING-FONG CHEN CHII-MING LEE |
公開日期: | 2010 | 卷: | 51 | 期: | 6 | 起(迄)頁: | 906-912 | 來源出版物: | Journal of Nuclear Medicine | 摘要: | Cardiac allograft vasculopathy (CAV) is the major determinant of long-term survival after heart transplantation. We aimed to evaluate the efficacy of PET as a noninvasive way to assess the early stages of CAV. Methods: Twenty-seven consecutive patients (20 men and 7 women; mean age ± SD, 46 ± 12 y) who had normal results on coronary angiography and normal left ventricular systolic function (ejection fraction ? 60%) were enrolled at 2.5 ± 2.1 y after transplantation. Myocardial blood flow (MBF) was assessed using dynamic 13N-ammonia PET at rest and during adenosine-induced hyperemia, and myocardial perfusion reserve (MPR) was calculated as the ratio of hyperemic MBF to resting MBF. Regional 13N-ammonia PET was assessed using a 5-point scoring system. The intravascular ultrasound (IVUS) measurements for the extent of intimal hyperplasia, including plaque volume index (calculated as [total plaque volume/total vessel volume] × 100%) and maximum area of stenosis, were compared with MPR by linear regression analysis. Results: In 27 angiographically normal cardiac transplant recipients, MBF at rest and during adenosine stress and MPR of the left anterior descending artery distribution correlated strongly with the other 2 coronary artery distribution territories (r ? 0.97, P < 0.0001). Summed stress score and summed difference score showed a moderate inverse correlation with MPR (r = -0.41 and -0.49, respectively; P < 0.05) but not with IVUS measurements. MPR correlated inversely with plaque volume index (r = -0.40, P < 0.05) but not with maximal luminal stenosis as assessed by IVUS. In addition, MPR and IVUS measurements gradually inversely changed after heart transplantation (all P < 0.05). Conclusion: This study confirms that CAV is a progressive process, diffusely involving the epicardial and microvascular coronary system. Plaque burden as determined by IVUS agrees well with MPR as assessed by PET in recipients with normal coronary angiography results. This finding suggests that dynamic 13N-ammonia PET is clinically feasible for the early detection of CAV and can be used as a reliable marker of disease progression. COPYRIGHT ? 2010 by the Society of Nuclear Medicine, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-77953920164&doi=10.2967%2fjnumed.109.073833&partnerID=40&md5=a7fc630ec4f87d0330b713b0ce341616 https://scholars.lib.ntu.edu.tw/handle/123456789/471020 |
ISSN: | 0161-5505 | DOI: | 10.2967/jnumed.109.073833 | SDG/關鍵字: | adenosine; ammonia; nitrogen 13; diagnostic agent; adult; aged; angiocardiography; artery intima proliferation; artery occlusion; article; atherosclerotic plaque; cardiac allograft vasculopathy; clinical article; diagnostic accuracy; diagnostic value; disease course; disease marker; female; graft recipient; heart ejection fraction; heart muscle blood flow; heart muscle perfusion; heart transplantation; human; hyperemia; intravascular ultrasound; left anterior descending coronary artery; male; positron emission tomography; priority journal; scoring system; systolic blood pressure; chemistry; coronary blood vessel; echography; endoscopic echography; heart; heart transplantation; middle aged; pathophysiology; scintiscanning; time; vascular disease; Adult; Aged; Ammonia; Coronary Angiography; Coronary Vessels; Female; Heart; Heart Transplantation; Humans; Male; Middle Aged; Positron-Emission Tomography; Time Factors; Ultrasonography, Interventional; Vascular Diseases; Young Adult |
顯示於: | 醫學系 |
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