Myocardial Perfusion Pattern In Patients With Different Degrees Of Coronary Artery Stenosis

Zavadovsky K.V., Saushkin V.V., Grakova E.V., Gulya M.O., Mochula A.V.

Purpose. To study myocardial perfusion in relation with coronary computed tomography angiography in patients with nonsignificant, intermediate and significant coronary artery stenosis. Materials and methods. 102 patients (64 males) aged 62.9±7.5 years with stable CAD (22% - low; 74% - intermediate and 4% - high pretest probability) were referred for hybrid cardiac SPECT/CT. Based on MDCT data, we analyzed the presence and degree of coronary artery stenosis as well as segment involvement score and segment stenosis score. Based on SPECT data, we analyzed summed stress score (SSS), summed rest score (SRS), summed difference score (SDS), total stress (TSE) and total rest extents (TRE) of perfusion, extent of normal myocardium (TENorm) extent of fixed perfusion defect (TEFix), and extent of reversible perfusion defect (TERev). All patients were divided in three groups: coronary artery stenosis <40% (group I); intermediate coronary artery stenosis >40-<7 0% (group II); coronary artery stenosis >70% (group III). Results. The most significant differences for groups II and III were founded between the following SPECT indexes: SSS [4,0 (3,0;6.5) and 8.0 (3.0;13.0); p=0.004]; SDS [3.0 (3.0;4.0) and 6.0 (3.0;8.0); p=0.02]; TSE [5 (3.0;10.0)% and 22.0 (13.0;39.0)%; p<0.001]; TENorm [93.0 (89.0;97.0)% and 70.0 (61.0;85.0)%; p<0.001]; TERev [4.0 (2.0;11.0)%; and 26.0 (15.0;30.0)%; p<0.001]. Segment involvement score had weak and moderate correlation relationships with SSS (r=0.23; p=0.02); TSE (r=0.20; p=0.04); SDS (r=0.27; p=0.01); TENorm (r=-0.44; p<0.001); TERev (r=0.33; p=0.003). Segment Stenosis Score had weak and moderate correlation relationships with SSS (r=0.37; p=0.0002), TSE (r=0.33; p=0.0008); SDS (r=0.37; p=0.0006); TENorm (r=-0.53; p<0.001); TERev (r=0.40; p=0.0002). Conclusions. Stress extent as well as extent of reversible perfusion defect and extent of normal myocardium have more significant differences between patients with angiographi-cally intermediate and significant stenosis. Segment stenosis score showed more strong cor-relation with SPECT myocardial perfusion indexes in comparison with segment involvement score.
1 - Moscow municipal oncologic hospital № 62. 2 - I.M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia.







Keywords:coronary artery disease, myocardial perfusion imaging, coronary computed tomography angiography.


Corresponding author:Zavadovsky K.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript /p>


For citation: Zavadovsky K.V., Saushkin V.V., Grakova E.V., Gulya M.O., Mochula A.V. Myocardial perfusion pattern in patients with different degrees of coronary artery stenosis. REJR 2017; 7(4): 39-54. DOI:10.21569/2222-7415-2017-7-4-39-54.

Received: 19.10.2017 Accepted: 16.11.2017