Morphologic and functional assessment of coronary artery disease - Potential application of computed tomography angiography and myocardial perfusion imaging

Sadako Motoyama, Masayoshi Sarai, Kaori Inoue, Hideki Kawai, Hajime Ito, Hiroto Harigaya, Kayoko Takada, Yoshihiro Sanda, Hirofumi Anno, Hiroyuki Naruse, Junichi Ishii, Yukio Ozaki

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: The role of combined evaluation of myocardial perfusion imaging (MPI; by single-photon emission computed tomography) and computed tomography angiography (CTA) for risk stratification of coronary artery disease was evaluated. For CTA, the extent of luminal stenosis, and also the features of high-risk plaques (HRP, including positive remodeling and low attenuation) were evaluated. Methods and Results: A total of 304 patients (65±11 years, male 72%, median follow-up: 24 months) who underwent CTA and MPI were enrolled in the study. Summed stress scores and summed difference scores (SDS) for MPI, stenosis, and HRP were evaluated, and event rates were compared. Cardiac events were defined as acute coronary event including cardiac death or non-fatal acute myocardial infarction, and unstable angina requiring revascularization. Of 304 patients, 51 (16.8%) underwent early revascularization. In the remaining 253 patients, an event occurred in 11 (4.3%). HRP (hazard ratio [HR], 4.75, P=0.00171) and stenosis (+) with SDS >0 (HR, 4.58, P=0.0461) were significant independent predictors of cardiac event. The event rate for stenosis (+) with SDS >0 was significantly higher than others (log-rank P=0.0490). The event rates were significantly different between HRP(+) and HRP(-) (16.1% vs. 2.7%, log-rank P=0.0013). Conclusions: HRP on CTA was an independent predictor of acute coronary events, as was stenosis (+) with SDS >0, and HRP had increased prognostic value over stenosis and abnormal MPI findings.

Original languageEnglish
Pages (from-to)411-417
Number of pages7
JournalCirculation Journal
Volume77
Issue number2
DOIs
Publication statusPublished - 04-02-2013

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Myocardial Perfusion Imaging
Coronary Artery Disease
Pathologic Constriction
Unstable Angina
Computed Tomography Angiography
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Motoyama, Sadako ; Sarai, Masayoshi ; Inoue, Kaori ; Kawai, Hideki ; Ito, Hajime ; Harigaya, Hiroto ; Takada, Kayoko ; Sanda, Yoshihiro ; Anno, Hirofumi ; Naruse, Hiroyuki ; Ishii, Junichi ; Ozaki, Yukio. / Morphologic and functional assessment of coronary artery disease - Potential application of computed tomography angiography and myocardial perfusion imaging. In: Circulation Journal. 2013 ; Vol. 77, No. 2. pp. 411-417.
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title = "Morphologic and functional assessment of coronary artery disease - Potential application of computed tomography angiography and myocardial perfusion imaging",
abstract = "Background: The role of combined evaluation of myocardial perfusion imaging (MPI; by single-photon emission computed tomography) and computed tomography angiography (CTA) for risk stratification of coronary artery disease was evaluated. For CTA, the extent of luminal stenosis, and also the features of high-risk plaques (HRP, including positive remodeling and low attenuation) were evaluated. Methods and Results: A total of 304 patients (65±11 years, male 72{\%}, median follow-up: 24 months) who underwent CTA and MPI were enrolled in the study. Summed stress scores and summed difference scores (SDS) for MPI, stenosis, and HRP were evaluated, and event rates were compared. Cardiac events were defined as acute coronary event including cardiac death or non-fatal acute myocardial infarction, and unstable angina requiring revascularization. Of 304 patients, 51 (16.8{\%}) underwent early revascularization. In the remaining 253 patients, an event occurred in 11 (4.3{\%}). HRP (hazard ratio [HR], 4.75, P=0.00171) and stenosis (+) with SDS >0 (HR, 4.58, P=0.0461) were significant independent predictors of cardiac event. The event rate for stenosis (+) with SDS >0 was significantly higher than others (log-rank P=0.0490). The event rates were significantly different between HRP(+) and HRP(-) (16.1{\%} vs. 2.7{\%}, log-rank P=0.0013). Conclusions: HRP on CTA was an independent predictor of acute coronary events, as was stenosis (+) with SDS >0, and HRP had increased prognostic value over stenosis and abnormal MPI findings.",
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Morphologic and functional assessment of coronary artery disease - Potential application of computed tomography angiography and myocardial perfusion imaging. / Motoyama, Sadako; Sarai, Masayoshi; Inoue, Kaori; Kawai, Hideki; Ito, Hajime; Harigaya, Hiroto; Takada, Kayoko; Sanda, Yoshihiro; Anno, Hirofumi; Naruse, Hiroyuki; Ishii, Junichi; Ozaki, Yukio.

In: Circulation Journal, Vol. 77, No. 2, 04.02.2013, p. 411-417.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Morphologic and functional assessment of coronary artery disease - Potential application of computed tomography angiography and myocardial perfusion imaging

AU - Motoyama, Sadako

AU - Sarai, Masayoshi

AU - Inoue, Kaori

AU - Kawai, Hideki

AU - Ito, Hajime

AU - Harigaya, Hiroto

AU - Takada, Kayoko

AU - Sanda, Yoshihiro

AU - Anno, Hirofumi

AU - Naruse, Hiroyuki

AU - Ishii, Junichi

AU - Ozaki, Yukio

PY - 2013/2/4

Y1 - 2013/2/4

N2 - Background: The role of combined evaluation of myocardial perfusion imaging (MPI; by single-photon emission computed tomography) and computed tomography angiography (CTA) for risk stratification of coronary artery disease was evaluated. For CTA, the extent of luminal stenosis, and also the features of high-risk plaques (HRP, including positive remodeling and low attenuation) were evaluated. Methods and Results: A total of 304 patients (65±11 years, male 72%, median follow-up: 24 months) who underwent CTA and MPI were enrolled in the study. Summed stress scores and summed difference scores (SDS) for MPI, stenosis, and HRP were evaluated, and event rates were compared. Cardiac events were defined as acute coronary event including cardiac death or non-fatal acute myocardial infarction, and unstable angina requiring revascularization. Of 304 patients, 51 (16.8%) underwent early revascularization. In the remaining 253 patients, an event occurred in 11 (4.3%). HRP (hazard ratio [HR], 4.75, P=0.00171) and stenosis (+) with SDS >0 (HR, 4.58, P=0.0461) were significant independent predictors of cardiac event. The event rate for stenosis (+) with SDS >0 was significantly higher than others (log-rank P=0.0490). The event rates were significantly different between HRP(+) and HRP(-) (16.1% vs. 2.7%, log-rank P=0.0013). Conclusions: HRP on CTA was an independent predictor of acute coronary events, as was stenosis (+) with SDS >0, and HRP had increased prognostic value over stenosis and abnormal MPI findings.

AB - Background: The role of combined evaluation of myocardial perfusion imaging (MPI; by single-photon emission computed tomography) and computed tomography angiography (CTA) for risk stratification of coronary artery disease was evaluated. For CTA, the extent of luminal stenosis, and also the features of high-risk plaques (HRP, including positive remodeling and low attenuation) were evaluated. Methods and Results: A total of 304 patients (65±11 years, male 72%, median follow-up: 24 months) who underwent CTA and MPI were enrolled in the study. Summed stress scores and summed difference scores (SDS) for MPI, stenosis, and HRP were evaluated, and event rates were compared. Cardiac events were defined as acute coronary event including cardiac death or non-fatal acute myocardial infarction, and unstable angina requiring revascularization. Of 304 patients, 51 (16.8%) underwent early revascularization. In the remaining 253 patients, an event occurred in 11 (4.3%). HRP (hazard ratio [HR], 4.75, P=0.00171) and stenosis (+) with SDS >0 (HR, 4.58, P=0.0461) were significant independent predictors of cardiac event. The event rate for stenosis (+) with SDS >0 was significantly higher than others (log-rank P=0.0490). The event rates were significantly different between HRP(+) and HRP(-) (16.1% vs. 2.7%, log-rank P=0.0013). Conclusions: HRP on CTA was an independent predictor of acute coronary events, as was stenosis (+) with SDS >0, and HRP had increased prognostic value over stenosis and abnormal MPI findings.

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