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Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization
PURPOSE: We sought to assess the impact of coronary revascularization on myocardial perfusion and fractional flow reserve (FFR) in patients without a cardiac history, with prior myocardial infarction (MI) or non-MI percutaneous coronary intervention (PCI). Furthermore, we studied the impact of scar...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611874/ https://www.ncbi.nlm.nih.gov/pubmed/37561140 http://dx.doi.org/10.1007/s00259-023-06356-4 |
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author | Jukema, Ruurt A. de Winter, Ruben W. Hopman, Luuk H.G.A. Driessen, Roel S. van Diemen, Pepijn A. Appelman, Yolande Twisk, Jos W.R. Planken, R. Nils Raijmakers, Pieter G. Knaapen, Paul Danad, Ibrahim |
author_facet | Jukema, Ruurt A. de Winter, Ruben W. Hopman, Luuk H.G.A. Driessen, Roel S. van Diemen, Pepijn A. Appelman, Yolande Twisk, Jos W.R. Planken, R. Nils Raijmakers, Pieter G. Knaapen, Paul Danad, Ibrahim |
author_sort | Jukema, Ruurt A. |
collection | PubMed |
description | PURPOSE: We sought to assess the impact of coronary revascularization on myocardial perfusion and fractional flow reserve (FFR) in patients without a cardiac history, with prior myocardial infarction (MI) or non-MI percutaneous coronary intervention (PCI). Furthermore, we studied the impact of scar tissue. METHODS: Symptomatic patients underwent [(15)O]H(2)O positron emission tomography (PET) and FFR before and after revascularization. Patients with prior CAD, defined as prior MI or PCI, underwent scar quantification by magnetic resonance imaging late gadolinium enhancement. RESULTS: Among 137 patients (87% male, age 62.2 ± 9.5 years) 84 (61%) had a prior MI or PCI. The increase in FFR and hyperemic myocardial blood flow (hMBF) was less in patients with prior MI or non-MI PCI compared to those without a cardiac history (FFR: 0.23 ± 0.14 vs. 0.20 ± 0.12 vs. 0.31 ± 0.18, p = 0.02; hMBF: 0.54 ± 0.75 vs. 0.62 ± 0.97 vs. 0.91 ± 0.96 ml/min/g, p = 0.04). Post-revascularization FFR and hMBF were similar across patients without a cardiac history or with prior MI or non-MI PCI. An increase in FFR was strongly associated to hMBF increase in patients without a cardiac history or with prior MI/non-MI PCI (r = 0.60 and r = 0.60, p < 0.01 for both). Similar results were found for coronary flow reserve. In patients with prior MI scar was negatively correlated to hMBF increase and independently predictive of an attenuated CFR increase. CONCLUSIONS: Post revascularization FFR and perfusion were similar among patients without a cardiac history, with prior MI or non-MI PCI. In patients with prior MI scar burden was associated to an attenuated perfusion increase. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00259-023-06356-4. |
format | Online Article Text |
id | pubmed-10611874 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-106118742023-10-29 Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization Jukema, Ruurt A. de Winter, Ruben W. Hopman, Luuk H.G.A. Driessen, Roel S. van Diemen, Pepijn A. Appelman, Yolande Twisk, Jos W.R. Planken, R. Nils Raijmakers, Pieter G. Knaapen, Paul Danad, Ibrahim Eur J Nucl Med Mol Imaging Original Article PURPOSE: We sought to assess the impact of coronary revascularization on myocardial perfusion and fractional flow reserve (FFR) in patients without a cardiac history, with prior myocardial infarction (MI) or non-MI percutaneous coronary intervention (PCI). Furthermore, we studied the impact of scar tissue. METHODS: Symptomatic patients underwent [(15)O]H(2)O positron emission tomography (PET) and FFR before and after revascularization. Patients with prior CAD, defined as prior MI or PCI, underwent scar quantification by magnetic resonance imaging late gadolinium enhancement. RESULTS: Among 137 patients (87% male, age 62.2 ± 9.5 years) 84 (61%) had a prior MI or PCI. The increase in FFR and hyperemic myocardial blood flow (hMBF) was less in patients with prior MI or non-MI PCI compared to those without a cardiac history (FFR: 0.23 ± 0.14 vs. 0.20 ± 0.12 vs. 0.31 ± 0.18, p = 0.02; hMBF: 0.54 ± 0.75 vs. 0.62 ± 0.97 vs. 0.91 ± 0.96 ml/min/g, p = 0.04). Post-revascularization FFR and hMBF were similar across patients without a cardiac history or with prior MI or non-MI PCI. An increase in FFR was strongly associated to hMBF increase in patients without a cardiac history or with prior MI/non-MI PCI (r = 0.60 and r = 0.60, p < 0.01 for both). Similar results were found for coronary flow reserve. In patients with prior MI scar was negatively correlated to hMBF increase and independently predictive of an attenuated CFR increase. CONCLUSIONS: Post revascularization FFR and perfusion were similar among patients without a cardiac history, with prior MI or non-MI PCI. In patients with prior MI scar burden was associated to an attenuated perfusion increase. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00259-023-06356-4. Springer Berlin Heidelberg 2023-08-10 2023 /pmc/articles/PMC10611874/ /pubmed/37561140 http://dx.doi.org/10.1007/s00259-023-06356-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Jukema, Ruurt A. de Winter, Ruben W. Hopman, Luuk H.G.A. Driessen, Roel S. van Diemen, Pepijn A. Appelman, Yolande Twisk, Jos W.R. Planken, R. Nils Raijmakers, Pieter G. Knaapen, Paul Danad, Ibrahim Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization |
title | Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization |
title_full | Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization |
title_fullStr | Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization |
title_full_unstemmed | Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization |
title_short | Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization |
title_sort | impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611874/ https://www.ncbi.nlm.nih.gov/pubmed/37561140 http://dx.doi.org/10.1007/s00259-023-06356-4 |
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