Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction

  • Jingwei Pan (Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital) ;
  • Mingyuan Yuan (Department of Radiology, Affiliated Zhoupu Hospital, Shanghai University of Medicine and Health Science) ;
  • Mengmeng Yu (Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital) ;
  • Yajie Gao (Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital) ;
  • Chengxing Shen (Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital) ;
  • Yining Wang (Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College) ;
  • Bin Lu (Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
  • Jiayin Zhang (Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital)
  • Received : 2018.10.17
  • Accepted : 2019.01.14
  • Published : 2019.05.01
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Abstract

Objective: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). Materials and Methods: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. Results: The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = -0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = -0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). Conclusion: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.

Keywords

Acknowledgement

This study was supoorted by National Natural Science Foundation of China (Grant No.: 81671678, 81671673), Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (Grant No.: 20161428), Shanghai Key Discipline of Medical Imaging (No.: 2017ZZ02005), The National Key Research and Development Program of China (Grant No.: 2016YFC1300400, 2016YFC1300402), 2017 People's Livelihood Project Of PuDong Committee On Science And Technology In Shanghai (Grant No.: PKJ2017-Y39), Key And weak Specialty Construction Program of Pudong Health Bureau of Shanghai (Grant No.: PWZbr2017-11) and Shanghai Health Medical College Innovative collaborative project funding (Grant No.: SPCI-18-17-001).

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