Page 69 - ARNM-2-3

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
Association between Rb positron emission
82
tomography-derived regional myocardial blood
flow, severity of angiographic coronary artery

stenosis, and mortality in patients with chest pain

Cesia Gallegos * , Camila Trejo Paredes 1† , Jiun-Ruey Hu 1† ,
1
1
1
3
1
Edith L. Posada , Yuichi Saito , Alexandra Lansky , Samit Shah , Yi-Hwa Liu ,
2
1
1,4
1
Kim G. Smolderen , Carlos Mena-Hurtado , Albert J. Sinusas ,
and Edward J. Miller 1
1 Department of Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United
States of America
2 Department of Cardiology, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico
3 Department of Cardiology, School of Medicine, Teikyo University, Tokyo, Japan
4 Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut,
United States of America
† These authors contributed equally Abstract
to this work.
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*Corresponding author: Impairment in global myocardial flow reserve (MFR) on rubidium-82 ( Rb) positron
Cesia Gallegos emission tomography (PET) stress testing predicts cardiovascular events; however,
(cesia.gallegoskattan@yale.edu) the relationship between regional coronary artery territory myocardial blood flow
Citation: Gallegos C, Paredes CT, (MBF) and invasive coronary angiography is unknown. In this study, patients with
Hu J, et al. Association between acute chest pain who were referred for coronary angiography after abnormal PET
82 Rb positron emission tomography-
derived regional myocardial blood stress testing were evaluated. Both global and regional coronary territory stress and
82
flow, severity of angiographic rest MBF were derived using Rb PET. Coronary artery stenosis severity was assessed
coronary artery stenosis, and using quantitative coronary angiography (QCA) performed within 3 months of PET.
mortality in patients with chest A total of 189 patients were followed for a median of 4.1 years. The results showed
pain. Adv Radiother Nucl Med.
2024;2(3):3786. a weak correlation between regional MFR impairment (<1.7) and stenosis severity
doi: 10.36922/arnm.3786 in the left descending artery (r = −0.20, P = 0.005), left circumflex artery (r = −0.15,
Received: May 29, 2024 P = 0.042), and right coronary artery (r = −0.26, P < 0.001). In addition, a weak
correlation was observed between global MFR and stenosis in any vessel, in both
Accepted: July 27, 2024
binary and continuous analyses. However, impairment in MFR within any territory
Published Online: September 23, was associated with increased all-cause mortality in both unadjusted and adjusted
2024 analyses. In conclusion, this is the first large-scale study to examine the relationship
Copyright: © 2024 Author(s). between regional coronary territory MBF, coronary artery stenosis severity as
This is an Open-Access article assessed using QCA, and mortality. Although coronary territory MFR demonstrated
distributed under the terms of the
Creative Commons Attribution a weak correlation with coronary stenosis severity, impairment in per-territory MFR
License, permitting distribution, was significantly associated with increased all-cause mortality, suggesting that
and reproduction in any medium, mechanisms such as diffuse atherosclerosis and/or microvascular disease may be
provided the original work is
properly cited. contributing factors.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Myocardial blood flow; Myocardial flow reserve; Positron emission
regard to jurisdictional claims in
published maps and institutional tomography; Perfusion; Coronary microvascular disease
affiliations

Volume 2 Issue 3 (2024) 1 doi: 10.36922/arnm.3786