Bailly Matthieu, Thibault Frédérique, Courtehoux Maxime, Metrard Gilles, Angoulvant Denis, Ribeiro Maria Joao
Nuclear Medicine Department, CHR ORLEANS, Orleans, France.
Nuclear Medicine Department, CHRU TOURS, Tours, France.
Front Med (Lausanne). 2021 Jun 4;8:691893. doi: 10.3389/fmed.2021.691893. eCollection 2021.
The aim of this study was to assess the results of cadmium zinc telluride (CZT)- single-photon emission computed tomography (SPECT) myocardial flow reserve (MFR) in coronary artery disease (CAD) screening regarding clinical risk and its correlation to invasive coronary angiography (ICA). A total of 137 patients (61 male and 76 female) referred for CAD screening myocardial perfusion imaging (MPI) between November 2018 and April 2020 were included in the CFR-OR prospective trial. The 10-year risk of cardiovascular death according to the European Society of Cardiology (SCORE) was calculated. SPECT 1-day 99mTc-tetrofosmin protocol was acquired on CZT cardiac-dedicated pinhole cameras. Low-dose thoracic CT was used for coronary calcium score (CCS) evaluation. ICA, when performed within 3 months, was also analyzed. Mean SCORE and mean global MFR were, respectively, 4 ± 3.1% and 2.50 ± 0.74; 34 patients had impaired CFR (using a threshold of 2). There was a significant inverse correlation between MFR and SCORE ( = 0.006), gender ( = 0.019), and number of cardiovascular risk factors ( = 0.01). MFR was significantly reduced in patients with CCS above 1 ( = 0.01). No significant correlation was found between MFR and individual cardiovascular risk factors (dyslipidemia, hypertension, diabetes, or family history of CAD). A total of 23 patients underwent ICA. Global MFR SPECT sensitivity and specificity were 83.3 and 100 %, respectively, with an area under the curve of 0.94. Adding MFR to SPECT MPI for CAD screening on CZT camera may contribute to high-risk patient identification and enhance diagnostic performances. MFR could help physician decision to perform ICA.
本研究的目的是评估碲化镉锌（CZT）单光子发射计算机断层扫描（SPECT）心肌血流储备（MFR）在冠状动脉疾病（CAD）筛查中与临床风险的关系及其与有创冠状动脉造影（ICA）的相关性。2018年11月至2020年4月期间转诊进行CAD筛查心肌灌注成像（MPI）的137例患者（61例男性和76例女性）被纳入CFR-OR前瞻性试验。根据欧洲心脏病学会（SCORE）计算心血管死亡的10年风险。在CZT心脏专用针孔相机上采用SPECT 1日99mTc-替曲膦方案。低剂量胸部CT用于评估冠状动脉钙化评分（CCS）。对3个月内进行的ICA也进行了分析。平均SCORE和平均整体MFR分别为4±3.1%和2.50±0.74；34例患者的CFR受损（采用阈值2）。MFR与SCORE（r = 0.006）、性别（r = 0.019）和心血管危险因素数量（r = 0.01）之间存在显著负相关。CCS高于1的患者MFR显著降低（r = 0.01）。未发现MFR与个体心血管危险因素（血脂异常、高血压、糖尿病或CAD家族史）之间存在显著相关性。共有23例患者接受了ICA。整体MFR SPECT敏感性和特异性分别为83.3%和100%，曲线下面积为0.94。在CZT相机上为CAD筛查将MFR添加到SPECT MPI中可能有助于识别高危患者并提高诊断性能。MFR有助于医生决定是否进行ICA。
