A Comparison of Dynamic SPECT Coronary Flow Reserve with TIMI Frame Count in the Treatment of Non-Obstructive Epicardial Coronary Patients

Mingping He; Wenzheng Han; Chuan Shi; Ming Wang; Junheng Li; Wei He; Xinxin Xu; Qian Gan; Shaofeng Guan; Liang Zhang; Yang Chen; Xifeng Chang; Tianqi Li; Xinkai Qu

doi:10.2147/CIA.S429450

A Comparison of Dynamic SPECT Coronary Flow Reserve with TIMI Frame Count in the Treatment of Non-Obstructive Epicardial Coronary Patients

Clin Interv Aging. 2023 Nov 2:18:1831-1839. doi: 10.2147/CIA.S429450. eCollection 2023.

Authors

Mingping He^#¹, Wenzheng Han^#¹, Chuan Shi¹, Ming Wang¹, Junheng Li², Wei He², Xinxin Xu³, Qian Gan¹, Shaofeng Guan¹, Liang Zhang¹, Yang Chen¹, Xifeng Chang¹, Tianqi Li¹, Xinkai Qu¹

Affiliations

¹ Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People's Republic of China.
² Department of Nuclear Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People's Republic of China.
³ Clinical Research Center for Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

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.

Keywords: coronary flow reserve; dynamic single photon emission computed tomography; non-obstructive coronary; slow flow; thrombolysis in myocardial infarction frame count.

MeSH terms

Aged
Coronary Angiography
Coronary Artery Disease* / diagnostic imaging
Coronary Circulation*
Female
Humans
Male
Tomography, Emission-Computed, Single-Photon

Grants and funding

This work was supported by grant from Clinical medical research of Geriatric Coronary Disease Center (No. LCXZ2205), Project of Huadong Hospital clinical research (HDLC2022014), Clinical Research Plan of Shanghai Health and Family Planning Commission (No. 202040298) and Shanghai Municipal Key Clinical Specialty (No. shslczdzk02801).