Korean J Intern Med.  2017 Sep;32(5):847-854. 10.3904/kjim.2016.012.

Geographic and demographic variabilities of quantitative parameters in stress myocardial computed tomography perfusion

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea. hearthsk@hotmail.com
  • 3Department of Radiology, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 4Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
To evaluate the geographic and demographic variabilities of the quantitative parameters of computed tomography perfusion (CTP) of the left ventricular (LV) myocardium in patients with normal coronary artery on computed tomography angiography (CTA).
METHODS
From a multicenter CTP registry of stress and static computed tomography, we retrospectively recruited 113 patients (mean age, 60 years; 57 men) without perfusion defect on visual assessment and minimal (< 20% of diameter stenosis) or no coronary artery disease on CTA. Using semiautomatic analysis software, quantitative parameters of the LV myocardium, including the myocardial attenuation in stress and rest phases, transmural perfusion ratio (TPR), and myocardial perfusion reserve index (MPRI), were evaluated in 16 myocardial segments.
RESULTS
In the lateral wall of the LV myocardium, all quantitative parameters except for MPRI were significantly higher compared with those in the other walls. The MPRI showed consistent values in all myocardial walls (anterior to lateral wall: range, 25% to 27%; p = 0.401). At the basal level of the myocardium, all quantitative parameters were significantly lower than those at the mid- and apical levels. Compared with men, women had significantly higher values of myocardial attenuation and TPR. Age, body mass index, and Framingham risk score were significantly associated with the difference in myocardial attenuation.
CONCLUSIONS
Geographic and demographic variabilities of quantitative parameters in stress myocardial CTP exist in healthy subjects without significant coronary artery disease. This information may be helpful when assessing myocardial perfusion defects in CTP.

Keyword

Myocardial CT perfusion; Quantitative parameter; Geographic variability; Demographical variability

MeSH Terms

Angiography
Body Mass Index
Coronary Artery Disease
Coronary Vessels
Cytidine Triphosphate
Female
Healthy Volunteers
Humans
Male
Myocardium
Perfusion*
Retrospective Studies
Cytidine Triphosphate
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