Correlation between thallium-201 myocardial perfusion defects and the functional severity of coronary artery stenosis as assessed by pressure-derived myocardial fractional flow reserve

Circ J. 2002 Dec;66(12):1105-9. doi: 10.1253/circj.66.1105.

Abstract

Although a relationship between the coronary pressure-derived fractional flow reserve (FFR) and the presence of myocardial ischemia as demonstrated by radionuclide imaging has been reported in a select group of patients, it remains to be established whether this relation also holds true in actual clinical settings with a heterogeneous group of patients. Accordingly, 194 coronary vessels and their supply territories were evaluated in 165 consecutive patients with suspected or known coronary artery disease. An FFR <0.75, which is regarded as indicative of functionally important stenosis, showed a significant correlation with the redistribution of (201)Tl (p<0.0001), with a sensitivity of 79% and specificity of 73%. In 70 infarct-related coronary arteries, the sensitivity and specificity were 79% and 75%, respectively, whereas in the 124 remaining vessels that were not related to the myocardial infarct, the sensitivity and specificity were 80% and 72%, respectively. In addition, the FFR exhibited a significant inverse correlation with the (201)Tl reversibility score (r=-0.62; p<0.0001). These results suggest that the FFR has a significant relationship with scintigraphic evidence of myocardial ischemia and can be regarded as a marker of its presence or absence in patients in actual clinical settings.

MeSH terms

  • Aged
  • Blood Pressure*
  • Coronary Angiography
  • Coronary Circulation*
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / physiopathology*
  • Coronary Stenosis / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / diagnostic imaging
  • Sensitivity and Specificity
  • Severity of Illness Index*
  • Thallium Radioisotopes*
  • Tomography, Emission-Computed, Single-Photon

Substances

  • Thallium Radioisotopes