Validation of minimally invasive measurement of myocardial perfusion usingelectron beam computed tomography and application in human volunteers

Citation
Mr. Bell et al., Validation of minimally invasive measurement of myocardial perfusion usingelectron beam computed tomography and application in human volunteers, HEART, 81(6), 1999, pp. 628-635
Citations number
41
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
HEART
ISSN journal
13556037 → ACNP
Volume
81
Issue
6
Year of publication
1999
Pages
628 - 635
Database
ISI
SICI code
1355-6037(199906)81:6<628:VOMIMO>2.0.ZU;2-2
Abstract
Objectives-To measure myocardial perfusion using an estimate of intramyocar dial vascular volume obtained by electron beam computed tomography (EBCT) i n an animal model; to assess the feasibility and validity of measuring regi onal myocardial perfusion in human volunteers using the techniques develope d and validated in the animal studies. Methods-Measurements of myocardial perfusion with EBCT employing intravenou s contrast injections were compared with radioactive microsphere measuremen ts (flow 57 to 346 ml/100 g/min) in seven closed chest dogs. Fourteen human volunteers then underwent EBCT scans using intravenous contrast injections . Results-Mean (SEM) global intramyocardial vascular volume by EBCT was 7.6 ( 1.1)%. The correlation between global EBCT (y) and microsphere (x) perfusio n was y = 0.59x + 15.56 (r = 0.86) before, and y = 0.72x + 6.06 (r = 0.88) after correcting for intramyocardial vascular volume. Regional perfusion co rrelation was y = 0.75x + 23.84 (r = 0.82). Corresponding improvements in a greement between the two techniques were also seen using Bland-Altman plots . In the human subjects, mean resting global myocardial flow was 98 (6) ml/ 100 g/min, with homogeneous flow across all regions. In 10 of these subject s, perfusion was studied during coronary vasodilatation using intravenous a denosine. Global flow increased from 93 (5) ml/100 g/min at rest to 250 (19 ) ml/100 g/min during adenosine (p < 0.001), with an average perfusion rese rve ratio of 2.8 (0.2). Similar changes in regional perfusion were observed and were uniform throughout all regions, with a mean regional perfusion re serve ratio of 2.8 (0.3). Conclusions-Accounting for intramyocardial vascular volume improves the acc uracy of EBCT measurements of myocardial perfusion when using intravenous c ontrast injections. The feasibility of providing accurate measurements of g lobal and regional myocardial perfusion and perfusion reserve in people usi ng this minimally invasive technique has also been demonstrated.