Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction

Thomas H. Schindler, Xiao Li Zhang, Gabriella Vincenti, Leila Mhiri, Rene Nkoulou, Hanjoerg Just, Osman Ratib, Francois Mach, Magnus Dahlbom, Heinrich R. Schelbert

Research output: Contribution to journalArticle

Abstract

Background: We aimed to evaluate the diagnostic value of a positron emission tomography (PET)-measured heterogeneity in longitudinal myocardial blood flow (MBF) during cold pressor testing (CPT) and global MBF response to CPT from rest (ΔMBF) for identification of coronary vasomotor dysfunction. Methods and Results: In 35 patients CPT-induced alterations in epicardial luminal area were determined with quantitative angiography as the reference. MBF was assessed over the whole left ventricle as global MBF and regionally in the mid and mid-distal myocardium as MBF difference or MBF heterogeneity with nitrogen-13 ammonia and PET. The sensitivity and specificity of a longitudinal MBF difference during CPT in the identification of epicardial vasomotor dysfunction were significantly higher than the global ΔMBF to CPT (88% vs 79% and 82% vs 64%, respectively; P <.05). Combining both parameters resulted in an optimal sensitivity of 100% at the expense of an intermediate specificity of 73%. The diagnostic accuracy was higher for the combined analysis than that for the MBF difference alone and global ΔMBF alone (91% vs 86% and 74%, respectively; P <.05). Conclusions: The combined evaluation of a CPT-induced heterogeneity in longitudinal MBF and the change in global MBF from rest may emerge as a new promising analytic approach to further optimize the identification and characterization of coronary vasomotor dysfunction.

Original languageEnglish (US)
Pages (from-to)688-697
Number of pages10
JournalJournal of Nuclear Cardiology
Volume14
Issue number5
DOIs
StatePublished - Sep 2007
Externally publishedYes

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Positron-Emission Tomography
Ammonia
Heart Ventricles
Myocardium
Angiography
Nitrogen
Sensitivity and Specificity

Keywords

  • Blood flow
  • cold pressor test
  • coronary vasomotion
  • endothelium
  • positron emission tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction. / Schindler, Thomas H.; Zhang, Xiao Li; Vincenti, Gabriella; Mhiri, Leila; Nkoulou, Rene; Just, Hanjoerg; Ratib, Osman; Mach, Francois; Dahlbom, Magnus; Schelbert, Heinrich R.

In: Journal of Nuclear Cardiology, Vol. 14, No. 5, 09.2007, p. 688-697.

Research output: Contribution to journalArticle

Schindler, TH, Zhang, XL, Vincenti, G, Mhiri, L, Nkoulou, R, Just, H, Ratib, O, Mach, F, Dahlbom, M & Schelbert, HR 2007, 'Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction', Journal of Nuclear Cardiology, vol. 14, no. 5, pp. 688-697. https://doi.org/10.1016/j.nuclcard.2007.06.120
Schindler, Thomas H. ; Zhang, Xiao Li ; Vincenti, Gabriella ; Mhiri, Leila ; Nkoulou, Rene ; Just, Hanjoerg ; Ratib, Osman ; Mach, Francois ; Dahlbom, Magnus ; Schelbert, Heinrich R. / Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction. In: Journal of Nuclear Cardiology. 2007 ; Vol. 14, No. 5. pp. 688-697.
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AU - Zhang, Xiao Li

AU - Vincenti, Gabriella

AU - Mhiri, Leila

AU - Nkoulou, Rene

AU - Just, Hanjoerg

AU - Ratib, Osman

AU - Mach, Francois

AU - Dahlbom, Magnus

AU - Schelbert, Heinrich R.

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N2 - Background: We aimed to evaluate the diagnostic value of a positron emission tomography (PET)-measured heterogeneity in longitudinal myocardial blood flow (MBF) during cold pressor testing (CPT) and global MBF response to CPT from rest (ΔMBF) for identification of coronary vasomotor dysfunction. Methods and Results: In 35 patients CPT-induced alterations in epicardial luminal area were determined with quantitative angiography as the reference. MBF was assessed over the whole left ventricle as global MBF and regionally in the mid and mid-distal myocardium as MBF difference or MBF heterogeneity with nitrogen-13 ammonia and PET. The sensitivity and specificity of a longitudinal MBF difference during CPT in the identification of epicardial vasomotor dysfunction were significantly higher than the global ΔMBF to CPT (88% vs 79% and 82% vs 64%, respectively; P <.05). Combining both parameters resulted in an optimal sensitivity of 100% at the expense of an intermediate specificity of 73%. The diagnostic accuracy was higher for the combined analysis than that for the MBF difference alone and global ΔMBF alone (91% vs 86% and 74%, respectively; P <.05). Conclusions: The combined evaluation of a CPT-induced heterogeneity in longitudinal MBF and the change in global MBF from rest may emerge as a new promising analytic approach to further optimize the identification and characterization of coronary vasomotor dysfunction.

AB - Background: We aimed to evaluate the diagnostic value of a positron emission tomography (PET)-measured heterogeneity in longitudinal myocardial blood flow (MBF) during cold pressor testing (CPT) and global MBF response to CPT from rest (ΔMBF) for identification of coronary vasomotor dysfunction. Methods and Results: In 35 patients CPT-induced alterations in epicardial luminal area were determined with quantitative angiography as the reference. MBF was assessed over the whole left ventricle as global MBF and regionally in the mid and mid-distal myocardium as MBF difference or MBF heterogeneity with nitrogen-13 ammonia and PET. The sensitivity and specificity of a longitudinal MBF difference during CPT in the identification of epicardial vasomotor dysfunction were significantly higher than the global ΔMBF to CPT (88% vs 79% and 82% vs 64%, respectively; P <.05). Combining both parameters resulted in an optimal sensitivity of 100% at the expense of an intermediate specificity of 73%. The diagnostic accuracy was higher for the combined analysis than that for the MBF difference alone and global ΔMBF alone (91% vs 86% and 74%, respectively; P <.05). Conclusions: The combined evaluation of a CPT-induced heterogeneity in longitudinal MBF and the change in global MBF from rest may emerge as a new promising analytic approach to further optimize the identification and characterization of coronary vasomotor dysfunction.

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