Value of PET quantitative analysis of coronary physiology for the diagnosis and risk factors assess-ment of non-obstructive coronary microvascular disease
10.3760/cma.j.issn.2095-2848.2019.08.007
- VernacularTitle:PET心肌血流绝对定量对非阻塞性冠状动脉微血管疾病的诊断及危险因素评估
- Author:
Wanli GAI
1
;
Ping WU
;
Yunliang LIANG
;
Qiong WU
;
Zhifang WU
;
Huanzhen CHEN
;
Sijin LI
Author Information
1. 山西医科大学第一医院心内科
- Keywords:
Coronary artery disease;
Microvascular angina;
Myocardial perfusion imaging;
Positron-emission tomography;
Ammonia
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2019;39(8):478-483
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the myocardial blood flow and reserve function by rest and stress 13 N-NH3 PET myocardial perfusion imaging ( MPI) , and evaluate the diagnostic value of PET and risk fac-tors of non-obstructive coronary microvascular disease ( CMVD) type 1. Methods A total of 56 patients (28 males, 28 females;age:(52.0±7.6) years) with clinical suspected CMVD type 1 from April 2017 to December 2018 were prospectively enrolled. The coronary CT angiography, coronary angiography and other clinical data were recorded. All patients underwent one-day rest and stress 13 N-NH3 PET MPI. Images were analyzed and the absolute myocardial blood flow ( MBF) and coronary flow reserve ( CFR) were obtained. Patients were divided into CMVD type 1 ( CMVD) group and non-CMVD group. The differences between 2 groups were analyzed by two-sample t test and logistic regression. Results Among 56 patients, 20 patients were diagnosed as CMVD type 1, and 36 patients were excluded as non-CMVD group. The proportion of smoking and diabetes in the CMVD group was significantly higher than that in the non-CMVD group (χ2 val-ues:9.433 and 4.114, both P<0.05). The stress MBF ((2.37±0.61) vs (3.83±1.25) ml·min-1·g-1;t=-4.807, P<0.001) and CFR (2.67±0.60 vs 3.81±0.96;t=-4.751, P<0.001) were lower in smokers than those in non-smokers, and the stress MBF was lower in diabetes patients than that in non-diabetes patients ((2.63±0.98) vs (3.62±1.28) ml·min-1·g-1;t=-2.758, P=0.008). Smoking might be the risk factor for lower stress MBF (odd ratio (OR)=0.310, 95％ CI:0.114-0.880) and lower CFR (OR=0.278, 95％ CI:0. 080-0.894), and diabetes might be the risk factor for lower stress MBF (OR=0.254, 95％ CI:0.073-0. 887) . Conclusions PET MPI can be used for the diagnosis of CMVD type 1. Smoking and diabetes are likely to be associated with the onset of CMVD type 1.
