Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark.
Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Opgang 7, Herlev 2730, Denmark.
Eur Heart J Cardiovasc Imaging. 2024 Jun 28;25(7):986-995. doi: 10.1093/ehjci/jeae050.
Dynamic myocardial computed tomography (CT) perfusion (DM-CTP) can, in combination with coronary CT angiography (CCTA), provide anatomical and functional evaluation of coronary artery disease (CAD). However, normal values of myocardial blood flow (MBF) are needed to identify impaired myocardial blood supply in patients with suspected CAD. We aimed to establish normal values for MBF measured using DM-CTP, to assess the effects of age and sex, and to assess regional distribution of MBF.
A total of 82 healthy individuals (46 women) aged 45-78 years with normal coronary arteries by CCTA underwent either rest and adenosine stress DM-CTP (n = 30) or adenosine-induced stress DM-CTP only (n = 52). Global and segmental MBF were assessed. Global MBF at rest and during stress were 0.93 ± 0.42 and 3.58 ± 1.14 mL/min/g, respectively. MBF was not different between the sexes (P = 0.88 at rest and P = 0.61 during stress), and no correlation was observed between MBF and age (P = 0.08 at rest and P = 0.82 during stress). Among the 16 myocardial segments, significant intersegmental differences were found (P < 0.01), which was not related to age, sex, or coronary dominance.
MBF assessed by DM-CTP in healthy individuals with normal coronary arteries displays significant intersegmental heterogeneity which does not seem to be affected by age, sex, or coronary dominance. Normal values of MBF may be helpful in the clinical evaluation of suspected myocardial ischaemia using DM-CTP.
动态心肌计算机断层扫描（CT）灌注（DM-CTP）可与冠状动脉 CT 血管造影（CCTA）相结合，对冠状动脉疾病（CAD）进行解剖学和功能评估。然而，需要正常的心肌血流（MBF）值来识别疑似 CAD 患者的心肌血供受损。我们旨在建立使用 DM-CTP 测量的 MBF 的正常值，评估年龄和性别对其的影响，并评估 MBF 的区域性分布。
共有 82 名年龄在 45-78 岁且 CCTA 显示正常冠状动脉的健康个体（46 名女性）接受了静息和腺苷应激 DM-CTP（n=30）或仅腺苷诱导应激 DM-CTP（n=52）检查。评估了整体和节段性 MBF。静息和应激时的整体 MBF 分别为 0.93±0.42 和 3.58±1.14 mL/min/g。性别之间的 MBF 无差异（静息时 P=0.88，应激时 P=0.61），MBF 与年龄之间也没有相关性（静息时 P=0.08，应激时 P=0.82）。在 16 个心肌节段中，发现了显著的节段间差异（P<0.01），且这种差异与年龄、性别或冠状动脉优势无关。
在冠状动脉正常的健康个体中，通过 DM-CTP 评估的 MBF 显示出明显的节段间异质性，而这种异质性似乎不受年龄、性别或冠状动脉优势的影响。MBF 的正常值可能有助于使用 DM-CTP 对疑似心肌缺血进行临床评估。
