TY - JOUR
T1 - The potential of dynamic 99mTc-sestamibi cadmium zinc telluride-single-photon emission computed tomography camera assessing myocardial flow reserve in patients with heart failure with preserved ejection fraction
AU - Yoshida, Satoya
AU - Unno, Kazumasa
AU - Nanasato, Mamoru
AU - Niimi, Takanaga
AU - Inukai, Kohei
AU - Morisaki, Hidenori
AU - Hattori, Tomoki
AU - Hirose, Miku
AU - Hayashi, Takumi
AU - Uchida, Noriya
AU - Simoda, Masahiro
AU - Oishi, Hideo
AU - Ando, Monami
AU - Hirayama, Kenshi
AU - Takenaka, Masaki
AU - Maeda, Mayuho
AU - Yoshida, Ruka
AU - Ogura, Yasuhiro
AU - Suzuki, Hirohiko
AU - Furusawa, Kenji
AU - Morimoto, Ryota
AU - Kato, Katsuhiko
AU - Isobe, Satoshi
AU - Yoshida, Yukihiko
AU - Murohara, Toyoaki
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Aims: Coronary microvascular dysfunction (CMD) is related to the pathophysiology, mortality, and morbidity of heart failure with preserved ejection fraction (HFpEF). A novel single-photon emission computed tomography (SPECT) camera with cadmium zinc telluride (CZT) detectors allows for the quantification of absolute myocardial blood flow and myocardial flow reserve (MFR) in patients with coronary artery disease. However, the potential of CZT-SPECT assessing for CMD has never been evaluated in patients with HFpEF. Methods and results: The clinical records of 127 consecutive patients who underwent dynamic CZT-SPECT were retrospectively reviewed. Rest and stress scanning were started simultaneously with 3 and 9MBq/kg of 99mTc-sestamibi administration, respectively. Dynamic CZT-SPECT imaging data were analysed using a net-retention model with commercially available software. Transthoracic echocardiography was performed in all patients. The MFR value was significantly lower in the HFpEF group (mean ± SEM = 2.00 ± 0.097) than that in the non-HFpEF group (mean ± SEM = 2.74 ± 0.14, P = 0.0004). A receiver operating characteristic analysis indicated that if a cut-off value of 2.525 was applied, MFR could efficiently distinguish HFpEF from non-HFpEF. Heart failure with preserved ejection fraction had a consistently low MFR, regardless of the diastolic dysfunction score. Heart failure with preserved ejection fraction patients with MFR values lower than 2.075 had a significantly higher incidence of heart failure exacerbation. Conclusion: Myocardial flow reserve assessed by CZT-SPECT was significantly reduced in patients with HFpEF. A lower MFR was associated with a higher hospitalization rate in these patients. Myocardial flow reserve assessed by CZT-SPECT has the potential to predict future adverse events and stratify the severity of disease in patients with HFpEF.
AB - Aims: Coronary microvascular dysfunction (CMD) is related to the pathophysiology, mortality, and morbidity of heart failure with preserved ejection fraction (HFpEF). A novel single-photon emission computed tomography (SPECT) camera with cadmium zinc telluride (CZT) detectors allows for the quantification of absolute myocardial blood flow and myocardial flow reserve (MFR) in patients with coronary artery disease. However, the potential of CZT-SPECT assessing for CMD has never been evaluated in patients with HFpEF. Methods and results: The clinical records of 127 consecutive patients who underwent dynamic CZT-SPECT were retrospectively reviewed. Rest and stress scanning were started simultaneously with 3 and 9MBq/kg of 99mTc-sestamibi administration, respectively. Dynamic CZT-SPECT imaging data were analysed using a net-retention model with commercially available software. Transthoracic echocardiography was performed in all patients. The MFR value was significantly lower in the HFpEF group (mean ± SEM = 2.00 ± 0.097) than that in the non-HFpEF group (mean ± SEM = 2.74 ± 0.14, P = 0.0004). A receiver operating characteristic analysis indicated that if a cut-off value of 2.525 was applied, MFR could efficiently distinguish HFpEF from non-HFpEF. Heart failure with preserved ejection fraction had a consistently low MFR, regardless of the diastolic dysfunction score. Heart failure with preserved ejection fraction patients with MFR values lower than 2.075 had a significantly higher incidence of heart failure exacerbation. Conclusion: Myocardial flow reserve assessed by CZT-SPECT was significantly reduced in patients with HFpEF. A lower MFR was associated with a higher hospitalization rate in these patients. Myocardial flow reserve assessed by CZT-SPECT has the potential to predict future adverse events and stratify the severity of disease in patients with HFpEF.
KW - Cadmium zinc telluride equipped single-photon emission computed tomography camera
KW - Coronary microvascular dysfunction
KW - Dynamic scanning
KW - Heart failure with preserved ejection fraction
KW - Myocardial blood flow
KW - Myocardial flow reserve
UR - https://www.scopus.com/pages/publications/85159694771
UR - https://www.scopus.com/pages/publications/85159694771#tab=citedBy
U2 - 10.1093/ehjopen/oead028
DO - 10.1093/ehjopen/oead028
M3 - Article
AN - SCOPUS:85159694771
SN - 2752-4191
VL - 3
JO - European Heart Journal Open
JF - European Heart Journal Open
IS - 2
M1 - oead028
ER -