TY - JOUR

T1 - Myocardial perfusion assessed with cardiac computed tomography in women without coronary heart disease

AU - Bechsgaard, Daria Frestad

AU - Gustafsson, Ida

AU - Linde, Jesper James

AU - Kofoed, Klaus Fuglsang

AU - Prescott, Eva

AU - Hove, Jens Dahlgaard

PY - 2019

Y1 - 2019

N2 - Purpose: Combined coronary CT angiography and CT perfusion (CTP) is a novel, non-invasive, ‘one-stop’ diagnostic tool to rule out ischaemia in patients suspected for coronary artery disease (CAD). However, the normal myocardial perfusion pattern by static CTP in humans is poorly described. We aimed to investigate global and regional myocardial perfusion during rest and adenosine-induced hyperaemia in asymptomatic women without history of coronary heart disease (CHD). Methods: Using a 320-row CT scanner with a static protocol, semi-quantitative assessment of rest and stress CTP was performed in 34 asymptomatic middle-aged women without obstructive CAD (<50% stenosis) or history of CHD, and with normal exercise stress test and left ventricular (LV) function. Using a 16-segment model, we assessed global and regional values of LV myocardial perfusion reserve (MPR) and transmural perfusion ratio (TPR). Results: Mean±SD age was 56 ± 13 years. Resting and hyperaemic myocardial perfusion was heterogeneously distributed throughout the LV myocardium. During hyperaemia, global MPR increased by median (IQR) 158% (144–176) with the highest increase in the right coronary artery territory (171%; P<0.02). Rest and stress segmental TPR values ranged between 0.93-1.26 and 0.99-1.13, respectively, with the lowest values detected in the inferoseptal segments. No differences in perfusion parameters were found between participants with normal epicardial arteries and participants with non-significant epicardial atheromatosis (all P>0.05). Global perfusion parameters were not associated with age or menopausal status (all P>0.05). Conclusions: This descriptive study presents data on global and regional myocardial perfusion in a cohort of healthy middle-aged women.

AB - Purpose: Combined coronary CT angiography and CT perfusion (CTP) is a novel, non-invasive, ‘one-stop’ diagnostic tool to rule out ischaemia in patients suspected for coronary artery disease (CAD). However, the normal myocardial perfusion pattern by static CTP in humans is poorly described. We aimed to investigate global and regional myocardial perfusion during rest and adenosine-induced hyperaemia in asymptomatic women without history of coronary heart disease (CHD). Methods: Using a 320-row CT scanner with a static protocol, semi-quantitative assessment of rest and stress CTP was performed in 34 asymptomatic middle-aged women without obstructive CAD (<50% stenosis) or history of CHD, and with normal exercise stress test and left ventricular (LV) function. Using a 16-segment model, we assessed global and regional values of LV myocardial perfusion reserve (MPR) and transmural perfusion ratio (TPR). Results: Mean±SD age was 56 ± 13 years. Resting and hyperaemic myocardial perfusion was heterogeneously distributed throughout the LV myocardium. During hyperaemia, global MPR increased by median (IQR) 158% (144–176) with the highest increase in the right coronary artery territory (171%; P<0.02). Rest and stress segmental TPR values ranged between 0.93-1.26 and 0.99-1.13, respectively, with the lowest values detected in the inferoseptal segments. No differences in perfusion parameters were found between participants with normal epicardial arteries and participants with non-significant epicardial atheromatosis (all P>0.05). Global perfusion parameters were not associated with age or menopausal status (all P>0.05). Conclusions: This descriptive study presents data on global and regional myocardial perfusion in a cohort of healthy middle-aged women.

KW - CT perfusion

KW - myocardial perfusion reserve

KW - non-invasive imaging

KW - reference population

KW - stress testing

KW - transmural perfusion ratio

U2 - 10.1111/cpf.12542

DO - 10.1111/cpf.12542

M3 - Journal article

C2 - 30270499

AN - SCOPUS:85054168983

VL - 39

SP - 65

EP - 77

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

SN - 1475-0961

IS - 1

ER -