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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
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Detection of obstructive coronary artery disease using regadenoson stress and 82Rb PET/CT myocardial perfusion

Edward Hsiao1, Bilal Ali, Ron Blankstein

  • 1Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts; and.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|August 14, 2013
PubMed

Insights

Regadenoson (82)Rb myocardial perfusion PET imaging accurately detects obstructive coronary artery disease (CAD). Left ventricular ejection fraction (LVEF) reserve is high in patients without significant ischemia, indicating good diagnostic performance.

Area of Science:

  • Nuclear Medicine
  • Cardiology
  • Diagnostic Imaging

Background:

  • Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide.
  • Accurate non-invasive detection of obstructive CAD is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

  • To evaluate the diagnostic performance of regadenoson (82)Rb myocardial perfusion positron emission tomography (PET) imaging in detecting obstructive CAD.
  • To assess the correlation between left ventricular ejection fraction (LVEF) reserve and the presence and severity of CAD.

Main Methods:

  • A study involving 134 patients without known CAD was conducted, including those who underwent coronary angiography and those with a low pretest likelihood of CAD.
  • Regadenoson (82)Rb myocardial perfusion PET imaging was performed.
  • Left ventricular ejection fraction (LVEF) reserve was calculated as the difference between stress and rest LVEF.
  • The Duke score was utilized to estimate the extent of jeopardized myocardium.

Main Results:

  • Regadenoson PET demonstrated high sensitivity (92%) and specificity (77%) for detecting obstructive CAD.
  • The area under the receiver-operator-characteristic curve was 0.847, indicating excellent diagnostic accuracy.
  • High sensitivity (89%) was observed even in patients with single-vessel CAD.
  • Mean LVEF reserve was significantly higher in patients with normal myocardial perfusion or mild/moderate jeopardized myocardium compared to those with severe ischemia.

Conclusions:

  • Regadenoson (82)Rb myocardial perfusion PET imaging is an accurate method for detecting obstructive CAD.
  • LVEF reserve serves as a valuable indicator, being higher in patients without significant ischemia or angiographic jeopardized myocardium.
Abstract

Keywords:
82Rbcoronary angiographydiagnostic accuracyejection fractionregadenoson

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