among patients with normal pet myocardial perfusion imaging, is there a relationship between calcium...

Non Invasive Imaging A1014 JACC April 1, 2014 Volume 63, Issue 12 AMONG PATIENTS WITH NORMAL PET MYOCARDIAL PERFUSION IMAGING, IS THERE A RELATIONSHIP BETWEEN CALCIUM SCORE AND CORONARY FLOW RESERVE? Poster Contributions Hall C Saturday, March 29, 2014, 10:00 a.m.-10:45 a.m. Session Title: Cardiac Positron Emission Tomography: Current and Newer Applications Abstract Category: 16. Non Invasive Imaging: Nuclear Presentation Number: 1101-24 Authors: Mouaz H. Al-Mallah, Ihab Suleiman, King AbdulAziz Cardiac Center, Riyadh, Saudi Arabia Background: Noninvasive quantification of coronary flows reserve (CFR) using cardiac positron emission tomography (PET) adds incremental diagnostic and prognostic information. Likewise, coronary calcium scoring (CCS) is an established tool for the evaluation of patients with suspected coronary artery disease (CAD). The aim of this analysis is to determine if an elevated CCS predicted reductions in CFR among patients with normal relative myocardial perfusion imaging (MPI) on PET. Methods: We included 499 patients (mean age = 59.2 ± 12, 47% males) without known CAD, who had a normal rubidium-82 PET MPI (sum stress score < 2) and underwent a CCS in the same setting. A CFR more than ≥2.5 ml/min/g was considered normal. Correlation coefficient was calculated between CFR and CCS. Results: A total of 142 (28%) patients had normal CFR while 220 patients (44%) had zero CCS. Patients with abnormal CFR were older (61 ± 12 vs. 57 ± 10 yrs, p=0.001) with higher prevalence of diabetes (53% vs. 41%, p=0.015) and hypertension (88% vs. 81%, p=0.04). Patients with normal CFR tended to have lower mean CCS (78±230 vs. 114 ± 350, p=0.12). In addition, Spearman correlation showed no relationship between calcium score and MBF (r = −0.081; P = 0.07). Conclusion: In patients with normal relative MPI, CCS and CFR have no correlation. The wide variation in CFR at different levels of CCS suggests that CCS and CFR provide different yet complimentary information.The prognostic value of these findings need to evaluated in prospective outcome studies.

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Page 1: AMONG PATIENTS WITH NORMAL PET MYOCARDIAL PERFUSION IMAGING, IS THERE A RELATIONSHIP BETWEEN CALCIUM SCORE AND CORONARY FLOW RESERVE?

Non Invasive Imaging

A1014JACC April 1, 2014

Volume 63, Issue 12

aMong paTienTs wiTh norMal peT Myocardial perfUsion iMaging, is There a relaTionship BeTween calciUM score and coronary flow reserve?

Poster ContributionsHall CSaturday, March 29, 2014, 10:00 a.m.-10:45 a.m.

Session Title: Cardiac Positron Emission Tomography: Current and Newer ApplicationsAbstract Category: 16. Non Invasive Imaging: NuclearPresentation Number: 1101-24

Authors: Mouaz H. Al-Mallah, Ihab Suleiman, King AbdulAziz Cardiac Center, Riyadh, Saudi Arabia

Background: Noninvasive quantification of coronary flows reserve (CFR) using cardiac positron emission tomography (PET) adds incremental diagnostic and prognostic information. Likewise, coronary calcium scoring (CCS) is an established tool for the evaluation of patients with suspected coronary artery disease (CAD). The aim of this analysis is to determine if an elevated CCS predicted reductions in CFR among patients with normal relative myocardial perfusion imaging (MPI) on PET.

Methods: We included 499 patients (mean age = 59.2 ± 12, 47% males) without known CAD, who had a normal rubidium-82 PET MPI (sum stress score < 2) and underwent a CCS in the same setting. A CFR more than ≥2.5 ml/min/g was considered normal. Correlation coefficient was calculated between CFR and CCS.

results: A total of 142 (28%) patients had normal CFR while 220 patients (44%) had zero CCS. Patients with abnormal CFR were older (61 ± 12 vs. 57 ± 10 yrs, p=0.001) with higher prevalence of diabetes (53% vs. 41%, p=0.015) and hypertension (88% vs. 81%, p=0.04). Patients with normal CFR tended to have lower mean CCS (78±230 vs. 114 ± 350, p=0.12). In addition, Spearman correlation showed no relationship between calcium score and MBF (r = −0.081; P = 0.07).

conclusion: In patients with normal relative MPI, CCS and CFR have no correlation. The wide variation in CFR at different levels of CCS suggests that CCS and CFR provide different yet complimentary information.The prognostic value of these findings need to evaluated in prospective outcome studies.

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