Abstract 14053: Diagnosis of Functionally Significant Coronary Stenosis by Exercise Computed Tomography Myocardial Perfusion Imaging
Background: Several noninvasive CT-derived methods for evaluating the functional significance of coronary artery stenosis seen by computed tomography coronary angiography (CCTA) have been reported to correlate with fractional flow reserve (FFR) measured during invasive coronary angiography (ICA). Computed tomography myocardial perfusion imaging (CTMPI) following supine exercise has never been previously evaluated.
Methods and Results: We studied 32 consecutive patients with 55 coronary stenoses ≥50% by CCTA. CTMPI was performed after supine exercise (X-CTMPI) on an ergometer secured to the CT table, and the myocardial enhancement ratio (MER) between stenotic and normally perfused territories was determined for each stenosis. FFR <0.8, as measured during ICA was the reference for defining a significant coronary stenosis. In the per-patient analysis, a MER cutoff of 0.8 was best for identifying functionally significant stenosis: sensitivity was 95%, specificity 90%, positive predictive value 95%, negative predictive value 90% and accuracy 94%. Corresponding values in the per-stenosis analysis were 97%, 96%, 97%, 96%, and 96%, respectively.
Conclusion: X-CTMPI is feasible and accurate for assessing the functional significance of coronary stenosis.
Author Disclosures: M. Habis: None. S. Ghostine: None. A. Rohnean: None. A. Capderou: None. J. Paul: None.
- © 2014 by American Heart Association, Inc.