期刊论文详细信息
Journal of Nuclear Medicine
Typical Chest Pain and Normal Coronary Angiogram: Cardiac Risk Factor Analysis Versus PET for Detection of Microvascular Disease
Aliasghar Khorsand1  Gerold Porenta1  Manfred Zehetgruber1  Heinz Sochor1  Senta Graf1  Christian Pirich1  Clemens Novotny1  Kurt Kletter1  Marianne Gwechenberger1  Gerald Maurer1 
关键词: microvascular disease;    PET;    coronary flow reserve;    cardiac risk factors;   
DOI  :  
学科分类:医学(综合)
来源: Society of Nuclear Medicine
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【 摘 要 】

Angiography of patients with typical chest pain reveals normal epicardial coronary arteries in about 20%. Coronary flow reserve (CFR) determination is an elaborate, but helpful, task, as only the evidence of microvascular disease enables appropriate therapy. We prospectively evaluated the incidence of a dysfunctional microcirculation and searched for predictive parameters of a reduced CFR. Methods: In 79 consecutive patients (52 females, 27 males) with typical angina and a normal angiogram and 10 control subjects (6 females, 4 males), CFR was measured by 13N-ammonia rest/dipyridamole PET and correlated with clinical parameters individually and summarized as the number of risk factors (NRF) using an elaborated cardiac risk factor score. Results: Sixty-five percent of patients had a reduced CFR (CFR < 2.5). CFR correlated with NRF (r = 0.55, P < 0.001), systolic blood pressure (r = 0.46, P < 0.001), interventricular septal thickness (r = 0.33, P < 0.01), and age (r = 0.25, P = 0.02). Eighty-five percent of patients with a high risk factor score (NRF ≥ 5) had a reduced CFR. In contrast, 100% of our patients with a low risk factor score (NRF < 2) presented a normal CFR. In total, 55% of our patients could be allocated to either one of these groups. Conclusion: In about two thirds of patients, anginal pain can be explained by a reduced CFR. Risk factors have a cumulative negative effect on CFR. A clinical cardiac risk factor analysis enables estimation of individual probability of microvascular dysfunction in a significant proportion of these patients. However, CFR measurements are recommended for those with an intermediate NRF.

【 授权许可】

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