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Updated: Mar 13, 2026
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
Normal values of myocardial blood flow and flow reserve with rubidium-82 positron emission tomography in low-risk
Vincent Ngo1, François Harel1, Vincent Finnerty1
1Department of Medical Imaging, Institut de Cardiologie de Montréal, Université de Montréal, Montréal, Québec, Canada.
Background:
This study aims to establish lower reference values for myocardial blood flow (MBF) and myocardial flow reserve (MFR) measured by rubidium-82 (82Rb) myocardial perfusion imaging (MPI) in patients at a low risk for coronary artery disease (CAD).
Methods:
This single-center study included 3320 patients with very low risk of obstructive CAD who underwent dipyridamole 82Rb positron emission tomography MPI. Patients were grouped by biological sex and age (≤40, 41-50, 51-60, 61-70, 71-80, and ≥81 years). Lower reference limits were derived using the Hoffmann method.
Results:
Rest MBF increased with age in females (r = 0.104, P < 0.001) and males (r = 0.149, P < 0.001), while stress MBF and MFR decreased with age in both females (r = -0.344, P < 0.001; r = -0.440, P < 0.001) and males (r = -0.371, P < 0.001; r = -0.479, P < 0.001). Females had significantly higher rest and stress MBF and lower MFR than males (P < 0.001). MFR lower reference limits were 2.14, 2.11, 1.94, 1.77, 1.57, and 1.38 for females and 2.05, 2.32, 1.97, 1.92, 1.56, and 1.28 for males across the six age groups. Stress MBF lower reference limits were 2.46, 2.34, 2.23, 2.04, 1.84, and 1.59 mL/min/g for females and 1.85, 1.88, 1.65, 1.56, 1.33, and 1.20 mL/g/min for males across the six age groups.
Conclusions:
This study establishes sex- and age-specific lower reference limits for stress MBF and MFR in low-risk CAD patients. Females exhibited higher stress MBF and MFR than males, while both values declined with age in both sexes. These findings underscore the necessity of incorporating sex- and age-adjusted reference values when interpreting MBF and MFR in clinical practice.
Insights
This study establishes lower reference values for myocardial blood flow (MBF) and myocardial flow reserve (MFR) using rubidium-82 PET MPI in low-risk patients. Sex and age significantly impact these values, necessitating adjusted interpretations for accurate clinical assessment.
Area of Science:
- Cardiovascular imaging
- Nuclear cardiology
- Biomarkers of coronary artery disease
Background:
- Myocardial blood flow (MBF) and myocardial flow reserve (MFR) are crucial indicators of coronary artery disease (CAD).
- Establishing accurate reference values for MBF and MFR is essential for reliable interpretation of myocardial perfusion imaging (MPI).
- Rubidium-82 (82Rb) PET MPI is a widely used technique for assessing myocardial perfusion.
Purpose of the Study:
- To determine lower reference limits for MBF and MFR measured by 82Rb PET MPI.
- To investigate the influence of sex and age on these reference values in a low-risk population.
- To provide sex- and age-specific data for improved clinical interpretation of MPI results.
Main Methods:
- A single-center study involving 3,320 low-risk patients who underwent dipyridamole 82Rb PET MPI.
- Patients were stratified by biological sex and age groups.
- Lower reference limits were calculated using the Hoffmann method.
Main Results:
- Rest MBF increased with age in both sexes, while stress MBF and MFR decreased with age.
- Females demonstrated significantly higher rest and stress MBF, and lower MFR compared to males.
- Specific lower reference limits for stress MBF and MFR were provided for different sex and age strata.
Conclusions:
- This study successfully established sex- and age-specific lower reference limits for stress MBF and MFR in low-risk CAD patients.
- The findings highlight significant differences between sexes and a decline with age, emphasizing the need for adjusted interpretation.
- Incorporating these sex- and age-adjusted reference values is crucial for accurate clinical assessment of myocardial perfusion.
