Author + information
- Received October 6, 2011
- Revision received November 30, 2011
- Accepted December 5, 2011
- Published online April 1, 2012.
- Nils P. Johnson, MD, MS and
- K. Lance Gould, MD⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. K. Lance Gould, Weatherhead PET Center For Preventing and Reversing Atherosclerosis, University of Texas Medical School at Houston, 6431 Fannin Street, Room 4.256 MSB, Houston, Texas 77030
Noninvasive, absolute myocardial perfusion and coronary flow reserve (CFR) can be imaged by many techniques. However, such data must be interpreted for clinical application regardless of its source. Currently, no guide exists for physiological integration. Therefore, we propose 2-dimensional scatter plots of stress flow and CFR with superimposed thresholds for normal flow, reduced flow without ischemia, definite ischemia, and transmural infarction to allow for automatic and objective classification. Application of this schema to 1,500 studies demonstrates that flow capacity relates inversely to risk factors and atherosclerotic burden. Interpreting stress flow to make clinical decisions requires rest flow or CFR for broad application to all patients. Although relative uptake images alone are adequate for some patients, it can either under- or over-estimate flow capacity in many persons. Our standardized framework could prompt future studies leading to a trial of revascularization guided by absolute flow measurements.
Internal funding came from the Weatherhead PET Center for Preventing and Reversing Atherosclerosis. The authors have reported they have no relationships relevant to the contents of this paper to disclose
- Received October 6, 2011.
- Revision received November 30, 2011.
- Accepted December 5, 2011.
- American College of Cardiology Foundation