Clinical Interventions in Aging (Nov 2023)

A Comparison of Dynamic SPECT Coronary Flow Reserve with TIMI Frame Count in the Treatment of Non-Obstructive Epicardial Coronary Patients

  • He M,
  • Han W,
  • Shi C,
  • Wang M,
  • Li J,
  • He W,
  • Xu X,
  • Gan Q,
  • Guan S,
  • Zhang L,
  • Chen Y,
  • Chang X,
  • Li T,
  • Qu X

Journal volume & issue
Vol. Volume 18
pp. 1831 – 1839

Abstract

Read online

Mingping He,1,* Wenzheng Han,1,* Chuan Shi,1 Ming Wang,1 Junheng Li,2 Wei He,2 Xinxin Xu,3 Qian Gan,1 Shaofeng Guan,1 Liang Zhang,1 Yang Chen,1 Xifeng Chang,1 Tianqi Li,1 Xinkai Qu1 1Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China; 2Department of Nuclear Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China; 3Clinical Research Center for Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenzheng Han; Xinkai Qu, Department of Cardiology, Huadong Hospital Affiliated to Fudan University, No. 221, Yan’an Road (W), Shanghai, People’s Republic of China, Email [email protected]; [email protected]: Microvascular dysfunction in patients with non-obstructive epicardial coronary may aggravate patient’s symptoms or lead to various clinical events.Objective: To investigate the correlation between dynamic single photon emission computed tomography (D-SPECT) derived coronary flow reserve (CFR) and TIMI frame count (TFC) in patients with non-obstructive epicardial coronary patients.Methods: Patients with suspected or known stable CAD who were recommended to undergo invasive coronary angiography were prospectively enrolled in this study. Those who had non-obstructive coronary received TIMI frame count (TFC) and D-SPECT. A cut-off value of > 40 was defined as slow flow referred to TFC.Results: A total of 47 patients diagnosed with non-obstructive coronary were enrolled. The mean age of patients was 66.09 ± 8.36 years, and 46.8% were male. Dynamic SPECT derived coronary flow reserve (CFR) was significantly correlated with TIMI frame count in 3 epicardial coronary (LAD: r=− 0.506, P = 0.0003; LCX: r= − 0.532, P = 0.0001; RCA: r= − 0.657, P < 0.0001). The sensitivity and specificity of CFR in identifying abnormal TIMI frame count < 40 was 100.0% and 57.6% in LAD, 62.5% and 87.0% in LCX, 83.9% and 75.0% in RCA, respectively. The optimal CFR cut-off values were 2.02, 2.47, and 1.96 among the three vessels.Conclusion: In patients with non-obstructive coronary, CFR derived from D-SPECT was strongly correlated with TFC. This study demonstrates that that CFR may be an alternative non-invasive method for identifying slow flow in non-obstructive coronary.Keywords: dynamic single photon emission computed tomography, thrombolysis in myocardial infarction frame count, slow flow, non-obstructive coronary, coronary flow reserve

Keywords