Myocardial flow reserve derived from D-SPECT for evaluating non-culprit ischemic lesions in STEMI patients: comparison with quantitative flow ratio.
Objectives: This study sought to elucidate the diagnostic performance and concordance between myocardial flow reserve (MFR) derived from dynamic single-photon emission computed tomography (D-SPECT) and quantitative flow ratio (QFR) in evaluating non-culprit ischemic lesions following ST-elevation my...
| Publicado en: | European Journal of Nuclear Medicine & Molecular Imaging Vol. 52; no. 11; pp. 4242 - 4256 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Sep2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187672833&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187672833 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16197070 NPC jtl: European Journal of Nuclear Medicine & Molecular Imaging issn: 16197070 maglogo: N pubinfo: dt: Sep2025 vid: 52 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 187672833 184515730 10.1007/s00259-025-07223-0 187672833 ppf: 4242 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Myocardial flow reserve derived from D-SPECT for evaluating non-culprit ischemic lesions in STEMI patients: comparison with quantitative flow ratio. aug: au: Zhao, Maomao Xing, Erkun Zhao, Jing Chen, Fengmei Chen, Ming Lu, Andong Pan, Chenliang Bai, Lu Zhang, Jing Wa, Yongling Wang, Ting Zhao, Yanhang Niu, Xiaowei Bai, Ming affil: https://ror.org/05d2xpa49 Department of Cardiology, First Hospital of Lanzhou University, Lanzhou, Gansu, China sug: ab: Objectives: This study sought to elucidate the diagnostic performance and concordance between myocardial flow reserve (MFR) derived from dynamic single-photon emission computed tomography (D-SPECT) and quantitative flow ratio (QFR) in evaluating non-culprit ischemic lesions following ST-elevation myocardial infarction (STEMI). Additionally, the study investigated the integration of MFR with angiographic microvascular resistance (AMR) derived from coronary angiography to determine its utility in screening and stratifying non-culprit ischemic lesions. Background: The diagnostic performance and agreement between MFR and QFR in evaluating non-culprit ischemic lesions in STEMI patients with multivessel disease are unknown. Methods: This research encompassed a cohort of 106 STEMI patients with at least 1 intermediate non-culprit ischemic lesion, characterized by 40–80% diameter stenosis. After undergoing percutaneous coronary intervention, patients were evaluated using QFR and, approximately five days later, underwent D-SPECT to assess myocardial blood flow (MBF) and MFR. MFR was evaluated against QFR as a reference for diagnostic performance and agreement, including sensitivity analysis in vessels with normal microvascular function. Furthermore, MFR, combined with AMR, effectively screened and stratified non-culprit ischemic lesions. Non-culprit ischemic lesions were defined by QFR ≤ 0.80 and normal microvascular function by AMR < 255 mmHg*s/m. Results: Among non-culprit lesions, MFR predicted a QFR ≤ 0.80 with a sensitivity of 85%, specificity of 86%, and accuracy of 86%. The positive predictive value was 56%, and the negative predictive value was 96%. The MFR cut-off was 1.93, with an area under the receiver operating characteristic curve of 0.90 (95% CI: 0.84 to 0.94). MFR showed similar diagnostic performance in patients with normal microcirculation. Moreover, low MFR with normal AMR indicated non-culprit ischemic lesions caused solely by epicardial narrowing, while low MFR with abnormal AMR indicated ischemic lesions complicated by microvascular dysfunction. Conclusion: MFR derived from D-SPECT exhibits good diagnostic performance and moderate agreement in identifying non-culprit ischemic lesions in patients with STEMI. Combining AMR with MFR effectively screens and stratifies non-culprit ischemic lesions. Trial registration: ChiCTR.org.cn. ChiCTR2200059934. Registered 13 May 2022. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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