Related Experiment Video
Updated: Jul 11, 2025
Author Spotlight: Improved Localization and Monitoring of Coronary Flow Reserve Using Modified PLAX View in Mice
Published on: August 25, 2023
A Comparison of Dynamic SPECT Coronary Flow Reserve with TIMI Frame Count in the Treatment of Non-Obstructive
Mingping He1, Wenzheng Han1, Chuan Shi1
1Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People's Republic of China.
Insights
Coronary flow reserve (CFR) measured by dynamic single photon emission computed tomography (D-SPECT) strongly correlates with TIMI frame count (TFC) in patients with non-obstructive coronary artery disease. This suggests CFR is a viable non-invasive method for detecting slow coronary flow.
Area of Science:
- Cardiology
- Medical Imaging
- Vascular Biology
Background:
- Microvascular dysfunction in non-obstructive epicardial coronary artery disease can worsen symptoms and lead to adverse clinical events.
- Assessing coronary flow reserve (CFR) is crucial for managing patients with suspected or known coronary artery disease (CAD).
Purpose of the Study:
- To investigate the correlation between dynamic single photon emission computed tomography (D-SPECT) derived coronary flow reserve (CFR) and TIMI frame count (TFC).
- To evaluate CFR as a non-invasive marker for slow flow in patients with non-obstructive coronary artery disease.
Main Methods:
- Prospective enrollment of 47 patients with non-obstructive coronary artery disease undergoing invasive coronary angiography.
- Measurement of TIMI frame count (TFC) and dynamic single photon emission computed tomography (D-SPECT) derived coronary flow reserve (CFR).
- Definition of slow flow as TFC > 40.
Main Results:
- Significant correlations were found between CFR and TFC in the left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA).
- CFR demonstrated high sensitivity and variable specificity in identifying abnormal TFC across the three coronary arteries.
- Optimal CFR cut-off values for detecting slow flow were determined for LAD, LCX, and RCA.
Conclusions:
- Coronary flow reserve (CFR) derived from D-SPECT is strongly correlated with TIMI frame count (TFC) in patients with non-obstructive coronary artery disease.
- CFR may serve as a valuable non-invasive alternative for identifying slow coronary flow in this patient population.
Background:
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.
