Transluminal attenuation gradient derived from coronary CT angiography to predict ischemia in SPECT myocardial perfusion imaging: Effect of coronary cross-sectional area.

von Felten, Elia; Benz, Dominik C; Benetos, Georgios; Giannopoulos, Andreas A; Messerli, Michael; Gräni, Christoph; Fuchs, Tobias A; Gebhard, Catherine; Buechel, Ronny R; Kaufmann, Philipp A; Pazhenkottil, Aju P (2022). Transluminal attenuation gradient derived from coronary CT angiography to predict ischemia in SPECT myocardial perfusion imaging: Effect of coronary cross-sectional area. Journal of nuclear cardiology, 29(1), pp. 350-358. Springer 10.1007/s12350-020-02242-w

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BACKGROUND

Coronary computed tomography angiography (CCTA)-based transluminal attenuation gradient (TAG) was suggested to determine the functional significance of a stenosis. However, evidence that TAG acquired by wide-volume scanners can assess the hemodynamic significance of stenosis assessed by single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is lacking. Moreover, coronary cross-sectional area may influence TAG. Hence, we aimed at assessing the diagnostic value of TAG to predict ischemia in SPECT-MPI and the correlation between TAG and the transluminal cross-sectional area gradient (TCG).

METHODS

Patients undergoing CCTA and SPECT-MPI for suspected coronary artery disease were included. TAG and TCG were calculated measuring the mean vessel attenuation and the cross-sectional area along major coronary vessels at 5-mm intervals.

RESULTS

A total of 255 coronary arteries of 87 patients were included. TAG and TCG did not discriminate between coronary arteries with or without ischemia as assessed by SPECT-MPI (p = .44 and p = .25, respectively). The area under the curve to predict ischemia was not increased by adding TAG (0.88, 95% CI 0.83-0.92) or TCG (0.87, 95% CI 0.81-0.90) to CCTA alone (0.85, 95% CI 0.80-0.89). There was a significant correlation between TAG and TCG (r = 0.43; p < .001).

CONCLUSIONS

CCTA-derived TAG and TCG do not offer any value in predicting ischemia assessed by SPECT-MPI. TAG is partly affected by differences in the coronary luminal area.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Gräni, Christoph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1071-3581

Publisher:

Springer

Language:

English

Submitter:

Vjollca Coli

Date Deposited:

28 Dec 2022 07:27

Last Modified:

28 Dec 2022 23:07

Publisher DOI:

10.1007/s12350-020-02242-w

PubMed ID:

32613474

Uncontrolled Keywords:

Coronary artery disease computed tomography angiography single-photon emission computed tomography

BORIS DOI:

10.48350/176414

URI:

https://boris.unibe.ch/id/eprint/176414

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