Anna Székely, Katarina Steding-Ehrenborg, Daniel Ryd, Fredrik Hedeer, Kristian Valind, Shahnaz Akil, Cecilia Hindorf, Erik Hedström, David Erlinge, Håkan Arheden, Henrik Engblom
{"title":"疑似慢性冠状动脉综合征患者的定量心肌灌注应根据性别和合并症进行解释:心脏正电子发射断层扫描研究。","authors":"Anna Székely, Katarina Steding-Ehrenborg, Daniel Ryd, Fredrik Hedeer, Kristian Valind, Shahnaz Akil, Cecilia Hindorf, Erik Hedström, David Erlinge, Håkan Arheden, Henrik Engblom","doi":"10.1111/cpf.12854","DOIUrl":null,"url":null,"abstract":"<p>Diagnosis and treatment of patients with suspected chronic coronary syndrome (CCS) currently relies on the degree of coronary artery stenosis and its significance for myocardial perfusion. However, myocardial perfusion can be affected by factors other than coronary stenosis. The aim of this study was to investigate to what extent sex, age, diabetes, hypertension and smoking affect quantitative myocardial perfusion, beyond the degree of coronary artery stenosis, in patients with suspected or established CCS. Eighty-six patients [median age 69 (range 46−86) years, 24 females] planned for elective coronary angiography due to suspected or established CCS were included. All patients underwent cardiac <sup>13</sup>N-NH<sub>3</sub> positron emission tomography to quantify myocardial perfusion at rest and stress. Lowest myocardial perfusion (perfusion<sub>min</sub>) at stress and rest and lowest myocardial perfusion reserve (MPR<sub>min</sub>) for all vessel territories was used as dependent variables in a linear mixed model. Independent variables were vessel territory, degree of coronary artery stenosis (as a continuous variable of 0%−100% stenosis), sex, age, diabetes, hypertension and smoking habits. Degree of coronary artery stenosis (<i>p</i> < 0.001), male sex (1.8 ± 0.6 vs. 2.3 ± 0.6 mL/min/g, <i>p</i> < 0.001), increasing age (<i>p</i> = 0.025), diabetes (1.6 ± 0.5 vs. 2.0 ± 0.6 mL/min/g, <i>p</i> = 0.023) and smoking (1.9 ± 0.6 vs. 2.1 ± 0.6 mL/min/g, <i>p</i> = 0.052) were independently associated with myocardial perfusion<sub>min</sub> at stress. Degree of coronary artery stenosis (<i>p</i> < 0.001), age (<i>p</i> = 0.040), diabetes (1.8 ± 0.6 vs. 2.3 ± 0.7, <i>p</i> = 0.046) and hypertension (2.2 ± 0.7 vs. 2.5 ± 0.6, <i>p</i> = 0.033) were independently associated with MPR<sub>min</sub>. Sex, increasing age, diabetes, hypertension and smoking affect myocardial perfusion independent of coronary artery stenosis in patients with suspected or established CCS. Thus, these factors need to be considered when assessing the significance of reduced quantitative myocardial perfusion of patients with suspected or established CCS.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12854","citationCount":"0","resultStr":"{\"title\":\"Quantitative myocardial perfusion should be interpreted in the light of sex and comorbidities in patients with suspected chronic coronary syndrome: A cardiac positron emission tomography study\",\"authors\":\"Anna Székely, Katarina Steding-Ehrenborg, Daniel Ryd, Fredrik Hedeer, Kristian Valind, Shahnaz Akil, Cecilia Hindorf, Erik Hedström, David Erlinge, Håkan Arheden, Henrik Engblom\",\"doi\":\"10.1111/cpf.12854\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Diagnosis and treatment of patients with suspected chronic coronary syndrome (CCS) currently relies on the degree of coronary artery stenosis and its significance for myocardial perfusion. However, myocardial perfusion can be affected by factors other than coronary stenosis. The aim of this study was to investigate to what extent sex, age, diabetes, hypertension and smoking affect quantitative myocardial perfusion, beyond the degree of coronary artery stenosis, in patients with suspected or established CCS. Eighty-six patients [median age 69 (range 46−86) years, 24 females] planned for elective coronary angiography due to suspected or established CCS were included. All patients underwent cardiac <sup>13</sup>N-NH<sub>3</sub> positron emission tomography to quantify myocardial perfusion at rest and stress. Lowest myocardial perfusion (perfusion<sub>min</sub>) at stress and rest and lowest myocardial perfusion reserve (MPR<sub>min</sub>) for all vessel territories was used as dependent variables in a linear mixed model. Independent variables were vessel territory, degree of coronary artery stenosis (as a continuous variable of 0%−100% stenosis), sex, age, diabetes, hypertension and smoking habits. Degree of coronary artery stenosis (<i>p</i> < 0.001), male sex (1.8 ± 0.6 vs. 2.3 ± 0.6 mL/min/g, <i>p</i> < 0.001), increasing age (<i>p</i> = 0.025), diabetes (1.6 ± 0.5 vs. 2.0 ± 0.6 mL/min/g, <i>p</i> = 0.023) and smoking (1.9 ± 0.6 vs. 2.1 ± 0.6 mL/min/g, <i>p</i> = 0.052) were independently associated with myocardial perfusion<sub>min</sub> at stress. Degree of coronary artery stenosis (<i>p</i> < 0.001), age (<i>p</i> = 0.040), diabetes (1.8 ± 0.6 vs. 2.3 ± 0.7, <i>p</i> = 0.046) and hypertension (2.2 ± 0.7 vs. 2.5 ± 0.6, <i>p</i> = 0.033) were independently associated with MPR<sub>min</sub>. Sex, increasing age, diabetes, hypertension and smoking affect myocardial perfusion independent of coronary artery stenosis in patients with suspected or established CCS. Thus, these factors need to be considered when assessing the significance of reduced quantitative myocardial perfusion of patients with suspected or established CCS.</p>\",\"PeriodicalId\":10504,\"journal\":{\"name\":\"Clinical Physiology and Functional Imaging\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12854\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Physiology and Functional Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cpf.12854\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PHYSIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Physiology and Functional Imaging","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cpf.12854","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PHYSIOLOGY","Score":null,"Total":0}
Quantitative myocardial perfusion should be interpreted in the light of sex and comorbidities in patients with suspected chronic coronary syndrome: A cardiac positron emission tomography study
Diagnosis and treatment of patients with suspected chronic coronary syndrome (CCS) currently relies on the degree of coronary artery stenosis and its significance for myocardial perfusion. However, myocardial perfusion can be affected by factors other than coronary stenosis. The aim of this study was to investigate to what extent sex, age, diabetes, hypertension and smoking affect quantitative myocardial perfusion, beyond the degree of coronary artery stenosis, in patients with suspected or established CCS. Eighty-six patients [median age 69 (range 46−86) years, 24 females] planned for elective coronary angiography due to suspected or established CCS were included. All patients underwent cardiac 13N-NH3 positron emission tomography to quantify myocardial perfusion at rest and stress. Lowest myocardial perfusion (perfusionmin) at stress and rest and lowest myocardial perfusion reserve (MPRmin) for all vessel territories was used as dependent variables in a linear mixed model. Independent variables were vessel territory, degree of coronary artery stenosis (as a continuous variable of 0%−100% stenosis), sex, age, diabetes, hypertension and smoking habits. Degree of coronary artery stenosis (p < 0.001), male sex (1.8 ± 0.6 vs. 2.3 ± 0.6 mL/min/g, p < 0.001), increasing age (p = 0.025), diabetes (1.6 ± 0.5 vs. 2.0 ± 0.6 mL/min/g, p = 0.023) and smoking (1.9 ± 0.6 vs. 2.1 ± 0.6 mL/min/g, p = 0.052) were independently associated with myocardial perfusionmin at stress. Degree of coronary artery stenosis (p < 0.001), age (p = 0.040), diabetes (1.8 ± 0.6 vs. 2.3 ± 0.7, p = 0.046) and hypertension (2.2 ± 0.7 vs. 2.5 ± 0.6, p = 0.033) were independently associated with MPRmin. Sex, increasing age, diabetes, hypertension and smoking affect myocardial perfusion independent of coronary artery stenosis in patients with suspected or established CCS. Thus, these factors need to be considered when assessing the significance of reduced quantitative myocardial perfusion of patients with suspected or established CCS.
期刊介绍:
Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest.
Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.