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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Correlation of Angina Pectoris and Perfusion Decrease by Collateral Circulation in Single-Vessel Coronary Chronic

Sang-Geon Cho1, Ki Seong Park1, Sae-Ryung Kang1

  • 1Department of Nuclear Medicine, Chonnam National University Hospital, Gwang-ju, Korea.

Nuclear Medicine and Molecular Imaging
|March 5, 2016
PubMed

Insights

Angina pectoris in chronic total occlusion (CTO) patients is linked to reduced blood flow in donor heart muscle, correlating with collateral circulation grades. This study used myocardial perfusion imaging to assess these perfusion decreases.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Myocardial Perfusion Assessment

Background:

  • Chronic total occlusion (CTO) poses challenges in assessing myocardial viability and symptoms.
  • Collateral circulation plays a crucial role in supplying blood to ischemic territories in CTO patients.
  • Understanding the relationship between collateral flow and symptoms is vital for patient management.

Purpose of the Study:

  • To evaluate perfusion decrease in donor myocardium due to collateral circulation in CTO patients.
  • To correlate this perfusion decrease with the presence of angina pectoris.
  • To utilize myocardial perfusion single-photon emission computed tomography (MPS) for this evaluation.

Main Methods:

  • Thirty-six patients with single-vessel CTO underwent MPS and coronary angiography (CAG).
  • Collateral grades were assessed using the Rentrop grading system on CAG.
  • Perfusion defects and scores in donor and CTO territories were analyzed using MPS.

Main Results:

  • Symptomatic patients with ischemic CTO territories had higher perfusion scores in the CTO territory.
  • Symptomatic patients with nonischemic CTO territories showed higher summed stress and rest scores in donor territories.
  • Perfusion defects in donor territories increased significantly with higher Rentrop grades (p < 0.001).

Conclusions:

  • Angina pectoris in CTO patients is associated with either ischemia beyond the CTO or reduced perfusion in the donor myocardium.
  • Perfusion decrease in donor myocardium shows a positive correlation with collateral circulation grades.
  • MPS and CAG are valuable tools for assessing collateral function and its impact on symptoms in CTO.
Abstract

Keywords:
Angina pectorisCollateral circulationCoronary occlusionMyocardial perfusion imaging

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