TY - JOUR
T1 - Relationship of coronary calcium and myocardial perfusion in individuals with chest pain
T2 - Assessed by integrated rubidium-82 PET-CT
AU - Brown, T. L.Y.
AU - Merrill, J.
AU - Hill, P.
AU - Bengel, Frank Michael
PY - 2008/12/15
Y1 - 2008/12/15
N2 - Aim: The integrated value of coronary calcium scoring added to myocardial perfusion assessment in hybrid PET-CT imaging remains poorly defined. In the present study, we sought to determine the relationship between calcium burden, other risk factors, and tissue perfusion in a group of patients with chest pain and predominantly intermediate likelihood for coronary artery disease. Patients, methods: In 70 patients, coronary calcium scores (CCS) were obtained in addition to rest/dipyridamole stress 82Rb perfusion images using a GE Discovery Rx hybrid PET-CT system. From static perfusion images, summed rest, stress and difference scores (SRS, SSS, SDS) were calculated using a 20-segment model. Absolute CCS was determined according to Agatston and age-, gender-, and ethnicity-matched CCS percentiles were calculated using the MESA database. Results: SSS, SRS and SDS were abnormal (≥4) in 25 (36%), 17 (24%), and 12 (17%) patients. Mean CCS according to Agatston was 180 ± 446(range 0-2122), and CCS percentile was 42 ± 43(range 0-99). Absolute CCS correlated mildly but significantly with SSS (r = 0.31, p = 0.01), while CCS percentile did not (r = 0.11, p = 0.36). Of 49 patients with normal perfusion, 25 (57%) had CCS = 0, and 8 (18%) had a CCS percentile ≥75th. Of 35 patients with a CCS = 0, 26 (74%) had normal perfusion. Individuals in whom review of patient records revealed events during follow-up (n = 10) had significantly higher SSS than those where no events were recorded (6.0 ± 7.2 versus 2.9 ± 3.1, p = 0.03), and there was a trend towards higher CCS percentiles (62 ± 36 versus 35 ± 43, p = 0.06). Conclusion: Coronary calcifications and myocardial tissue perfusion, as interrogated in a single PET-CT imaging session, show only partial agreement in patients with chest pain. Both tests seem to reflect different pathophysiologic components, and may be complementary for definition of individual disease patterns.
AB - Aim: The integrated value of coronary calcium scoring added to myocardial perfusion assessment in hybrid PET-CT imaging remains poorly defined. In the present study, we sought to determine the relationship between calcium burden, other risk factors, and tissue perfusion in a group of patients with chest pain and predominantly intermediate likelihood for coronary artery disease. Patients, methods: In 70 patients, coronary calcium scores (CCS) were obtained in addition to rest/dipyridamole stress 82Rb perfusion images using a GE Discovery Rx hybrid PET-CT system. From static perfusion images, summed rest, stress and difference scores (SRS, SSS, SDS) were calculated using a 20-segment model. Absolute CCS was determined according to Agatston and age-, gender-, and ethnicity-matched CCS percentiles were calculated using the MESA database. Results: SSS, SRS and SDS were abnormal (≥4) in 25 (36%), 17 (24%), and 12 (17%) patients. Mean CCS according to Agatston was 180 ± 446(range 0-2122), and CCS percentile was 42 ± 43(range 0-99). Absolute CCS correlated mildly but significantly with SSS (r = 0.31, p = 0.01), while CCS percentile did not (r = 0.11, p = 0.36). Of 49 patients with normal perfusion, 25 (57%) had CCS = 0, and 8 (18%) had a CCS percentile ≥75th. Of 35 patients with a CCS = 0, 26 (74%) had normal perfusion. Individuals in whom review of patient records revealed events during follow-up (n = 10) had significantly higher SSS than those where no events were recorded (6.0 ± 7.2 versus 2.9 ± 3.1, p = 0.03), and there was a trend towards higher CCS percentiles (62 ± 36 versus 35 ± 43, p = 0.06). Conclusion: Coronary calcifications and myocardial tissue perfusion, as interrogated in a single PET-CT imaging session, show only partial agreement in patients with chest pain. Both tests seem to reflect different pathophysiologic components, and may be complementary for definition of individual disease patterns.
KW - Coronary calcium
KW - Hybrid imaging
KW - Myocardial perfusion
KW - PET-CT
KW - Rubidium-82
UR - http://www.scopus.com/inward/record.url?scp=57349139984&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57349139984&partnerID=8YFLogxK
U2 - 10.3413/nukmed-0176
DO - 10.3413/nukmed-0176
M3 - Article
C2 - 19057799
AN - SCOPUS:57349139984
VL - 47
SP - 255
EP - 260
JO - Nuklearmedizin
JF - Nuklearmedizin
SN - 0029-5566
IS - 6
ER -