Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCI

Background Patients after percutaneous coronary intervention (PCI) may still experience typical angina, potentially due to concomitant coronary microcirculation disturbance (CMD). Single-photon emission computed tomography (SPECT) serves as a non-invasive method for quantitatively assessing coronary...

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Main Author: JIA Shuo, CHENG Gong, GUAN Lei, FENG Panpan, XU Bailing, FANG Wei, ZHANG Ji
Format: Article
Language:zho
Published: Chinese General Practice Publishing House Co., Ltd 2025-03-01
Series:Zhongguo quanke yixue
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Online Access:https://www.chinagp.net/fileup/1007-9572/PDF/1735803174557-1471360929.pdf
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author JIA Shuo, CHENG Gong, GUAN Lei, FENG Panpan, XU Bailing, FANG Wei, ZHANG Ji
author_facet JIA Shuo, CHENG Gong, GUAN Lei, FENG Panpan, XU Bailing, FANG Wei, ZHANG Ji
author_sort JIA Shuo, CHENG Gong, GUAN Lei, FENG Panpan, XU Bailing, FANG Wei, ZHANG Ji
collection DOAJ
description Background Patients after percutaneous coronary intervention (PCI) may still experience typical angina, potentially due to concomitant coronary microcirculation disturbance (CMD). Single-photon emission computed tomography (SPECT) serves as a non-invasive method for quantitatively assessing coronary flow reserve (CFR) in CMD patients. However, research on its diagnostic performance in this population is limited. Objective To evaluate the diagnostic performance of SPECT in patients with CMD after PCI by using upgraded acquisition techniques and novel myocardial blood flow quantitative analysis software. Methods A total of 32 patients who still had typical angina symptoms after PCI for coronary artery disease in Shaanxi Provincial People's Hospital between November 2020 and November 2021 were included in the study. General data of the patients were collected. Coronary angiography was performed, the fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) were measured using a temperature/pressure guidewire, and patients with FFR>0.8 and no pericardial subvascular obstructive stenosis postoperatively were selected, encompassing 60 vessels in total. Pearson's test was used to explore the correlation between IMR and CFR. With IMR as the gold standard, a receiver operating characteristic (ROC) curve was plotted for CFR in diagnosing CMD, and the area under the ROC curve (AUC) was calculated. Results Twenty CMD patients were included in the study, comprising 15 males and 5 females, with an average age of (64.2±9.3) years. Of the 60 vessels included, 21 were left anterior descending, 17 were left circumflex, and 22 were right coronary arteries. Pearson's test showed a negative correlation between IMR and CFR (r=-0.526, P<0.001). The AUC for CFR in diagnosing CMD was 0.840 (95%CI=0.716-0.964), the truncation value is 1.985. Conclusion SPECT has demonstrated good diagnostic performance in patients after PCI. Upgraded acquisition techniques and novel myocardial blood flow quantitative analysis software make SPECT an effective tool for diagnosing the presence of CMD in patients without pericardial subvascular obstructive stenosis after PCI.
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spelling doaj-art-8b6062c2fc054e6a8e450d7a3cb3e50d2025-08-20T02:43:32ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722025-03-0128091122112710.12114/j.issn.1007-9572.2023.0536Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCIJIA Shuo, CHENG Gong, GUAN Lei, FENG Panpan, XU Bailing, FANG Wei, ZHANG Ji01. Department of Emergency Internal Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, China;2. Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an 710068, China;3. Department of Ultrasound, Shaanxi Provincial People's Hospital, Xi'an 710068, China;4. Department of General Practice, Shaanxi Provincial People's Hospital, Xi'an 710068, China;5. Nuclear Science and Engineering Ins., University of Missouri-Columbia, Columbia 65211, USA;6. Fuwai Hospital Chinese Academy of Medical Sciences, Beijing 100037, ChinaBackground Patients after percutaneous coronary intervention (PCI) may still experience typical angina, potentially due to concomitant coronary microcirculation disturbance (CMD). Single-photon emission computed tomography (SPECT) serves as a non-invasive method for quantitatively assessing coronary flow reserve (CFR) in CMD patients. However, research on its diagnostic performance in this population is limited. Objective To evaluate the diagnostic performance of SPECT in patients with CMD after PCI by using upgraded acquisition techniques and novel myocardial blood flow quantitative analysis software. Methods A total of 32 patients who still had typical angina symptoms after PCI for coronary artery disease in Shaanxi Provincial People's Hospital between November 2020 and November 2021 were included in the study. General data of the patients were collected. Coronary angiography was performed, the fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) were measured using a temperature/pressure guidewire, and patients with FFR>0.8 and no pericardial subvascular obstructive stenosis postoperatively were selected, encompassing 60 vessels in total. Pearson's test was used to explore the correlation between IMR and CFR. With IMR as the gold standard, a receiver operating characteristic (ROC) curve was plotted for CFR in diagnosing CMD, and the area under the ROC curve (AUC) was calculated. Results Twenty CMD patients were included in the study, comprising 15 males and 5 females, with an average age of (64.2±9.3) years. Of the 60 vessels included, 21 were left anterior descending, 17 were left circumflex, and 22 were right coronary arteries. Pearson's test showed a negative correlation between IMR and CFR (r=-0.526, P<0.001). The AUC for CFR in diagnosing CMD was 0.840 (95%CI=0.716-0.964), the truncation value is 1.985. Conclusion SPECT has demonstrated good diagnostic performance in patients after PCI. Upgraded acquisition techniques and novel myocardial blood flow quantitative analysis software make SPECT an effective tool for diagnosing the presence of CMD in patients without pericardial subvascular obstructive stenosis after PCI.https://www.chinagp.net/fileup/1007-9572/PDF/1735803174557-1471360929.pdfcoronary disease|coronary microcirculation disturbance|percutaneous transluminal coronary angioplasty|single photon emission computed tomography|clinical diagnostic value
spellingShingle JIA Shuo, CHENG Gong, GUAN Lei, FENG Panpan, XU Bailing, FANG Wei, ZHANG Ji
Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCI
Zhongguo quanke yixue
coronary disease|coronary microcirculation disturbance|percutaneous transluminal coronary angioplasty|single photon emission computed tomography|clinical diagnostic value
title Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCI
title_full Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCI
title_fullStr Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCI
title_full_unstemmed Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCI
title_short Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCI
title_sort diagnostic performance of spect in patients with coronary microcirculation disturbance after pci
topic coronary disease|coronary microcirculation disturbance|percutaneous transluminal coronary angioplasty|single photon emission computed tomography|clinical diagnostic value
url https://www.chinagp.net/fileup/1007-9572/PDF/1735803174557-1471360929.pdf
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