| Quantitative relationship between the extent and morphology of coronary atherosclerotic plaque and downstream myocardial perfusion. | |
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MedLine Citation:
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PMID: 21996395 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to quantify the effects of coronary atherosclerosis morphology and extent on myocardial flow reserve (MFR). BACKGROUND: Although the relationship between coronary stenosis and myocardial perfusion is well established, little is known about the contribution of other anatomic descriptors of atherosclerosis burden to this relationship. METHODS: We evaluated the relationship between atherosclerosis plaque burden, morphology, and composition and regional MFR (MFR(regional)) in 73 consecutive patients undergoing Rubidium-82 positron emission tomography and coronary computed tomography angiography for the evaluation of known or suspected coronary artery disease. RESULTS: Atherosclerosis was seen in 51 of 73 patients and in 107 of 209 assessable coronary arteries. On a per-vessel basis, the percentage diameter stenosis (p = 0.02) or summed stenosis score (p = 0.002), integrating stenoses in series, was the best predictor of MFR(regional). Importantly, MFR(regional) varied widely within each coronary stenosis category, even in vessels with nonobstructive plaques (n = 169), 38% of which had abnormal MFR(regional) (<2.0). Total plaque length, composition, and remodeling index were not associated with lower MFR. On a per-patient basis, the modified Duke CAD (coronary artery disease) index (p = 0.04) and the number of segments with mixed plaque (p = 0.01) were the best predictors of low MFR(global). CONCLUSIONS: Computed tomography angiography descriptors of atherosclerosis had only a modest effect on downstream MFR. On a per-patient basis, the extent and severity of atherosclerosis as assessed by the modified Duke CAD index and the number of coronary segments with mixed plaque were associated with decreased MFR. |
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Authors:
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Masanao Naya; Venkatesh L Murthy; Ron Blankstein; Arkadiusz Sitek; Jon Hainer; Courtney Foster; Mariya Gaber; Jolene M Fantony; Sharmila Dorbala; Marcelo F Di Carli |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 58 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-14 Completed Date: 2011-12-07 Revised Date: 2012-05-14 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1807-16 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiology), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Angiography Coronary Artery Disease / physiopathology, radiography*, radionuclide imaging Coronary Circulation* Female Humans Male Middle Aged Plaque, Atherosclerotic / physiopathology, radiography*, radionuclide imaging Positron-Emission Tomography Tomography, X-Ray Computed |
| Grant Support | |
ID/Acronym/Agency:
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T32 HL094301/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2011 Oct 18;58(17):1817-8
[PMID:
21996396
]
J Am Coll Cardiol. 2012 Apr 10;59(15):1407-8; author reply 1408 [PMID: 22480481 ] |
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