Fractional Flow Reserve of Infarct-Related Arteries Identifies Reversible Defects on Noninvasive Myocardial Perfusion Imaging Early After Myocardial Infarction

Habib Samady, Wolfgang Lepper, Eric R. Powers, Kevin Wei, Michael Ragosta, Gregory G. Bishop, Ian J. Sarembock, Lawrence Gimple, Denny D. Watson, George A. Beller, Kurt G. Barringhaus

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    Abstract

    Objectives: We hypothesized that fractional flow reserve (FFR) of an infarct-related artery (IRA) early after myocardial infarction (MI) identifies inducible ischemia on noninvasive imaging. Background: Early after MI, IRAs frequently have angiographically indeterminant lesions. Whether FFR can detect reversible perfusion defects early after MI when dynamic microvascular abnormalities are present is not known. Methods: Rest and dipyridamole (DP)-stress 99mTc sestamibi single-photon emission computed tomography (SPECT) were performed in 48 patients 3.7 ± 1.3 days after MI, with 23 patients undergoing concurrent myocardial contrast echocardiography (MCE). Angiography, FFR, and percutaneous coronary intervention (PCI) of the IRA (as necessary) were subsequently performed. Follow-up SPECT was performed 11 weeks after PCI to identify true reversibility on baseline SPECT. Results: The sensitivity, specificity, positive and negative predictive value, and concordance of FFR ≤0.75 for detecting reversibility on SPECT were 88%, 50%, 68%, 89%, and 71% (chi-square

    Original languageEnglish (US)
    Pages (from-to)2187-2193
    Number of pages7
    JournalJournal of the American College of Cardiology
    Volume47
    Issue number11
    DOIs
    StatePublished - Jun 6 2006

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    Myocardial Perfusion Imaging
    Single-Photon Emission-Computed Tomography
    Arteries
    Myocardial Infarction
    Percutaneous Coronary Intervention
    Technetium Tc 99m Sestamibi
    Dipyridamole
    Echocardiography
    Angiography
    Ischemia
    Perfusion
    Sensitivity and Specificity

    ASJC Scopus subject areas

    • Nursing(all)

    Cite this

    Fractional Flow Reserve of Infarct-Related Arteries Identifies Reversible Defects on Noninvasive Myocardial Perfusion Imaging Early After Myocardial Infarction. / Samady, Habib; Lepper, Wolfgang; Powers, Eric R.; Wei, Kevin; Ragosta, Michael; Bishop, Gregory G.; Sarembock, Ian J.; Gimple, Lawrence; Watson, Denny D.; Beller, George A.; Barringhaus, Kurt G.

    In: Journal of the American College of Cardiology, Vol. 47, No. 11, 06.06.2006, p. 2187-2193.

    Research output: Contribution to journalArticle

    Samady, Habib ; Lepper, Wolfgang ; Powers, Eric R. ; Wei, Kevin ; Ragosta, Michael ; Bishop, Gregory G. ; Sarembock, Ian J. ; Gimple, Lawrence ; Watson, Denny D. ; Beller, George A. ; Barringhaus, Kurt G. / Fractional Flow Reserve of Infarct-Related Arteries Identifies Reversible Defects on Noninvasive Myocardial Perfusion Imaging Early After Myocardial Infarction. In: Journal of the American College of Cardiology. 2006 ; Vol. 47, No. 11. pp. 2187-2193.
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    abstract = "Objectives: We hypothesized that fractional flow reserve (FFR) of an infarct-related artery (IRA) early after myocardial infarction (MI) identifies inducible ischemia on noninvasive imaging. Background: Early after MI, IRAs frequently have angiographically indeterminant lesions. Whether FFR can detect reversible perfusion defects early after MI when dynamic microvascular abnormalities are present is not known. Methods: Rest and dipyridamole (DP)-stress 99mTc sestamibi single-photon emission computed tomography (SPECT) were performed in 48 patients 3.7 ± 1.3 days after MI, with 23 patients undergoing concurrent myocardial contrast echocardiography (MCE). Angiography, FFR, and percutaneous coronary intervention (PCI) of the IRA (as necessary) were subsequently performed. Follow-up SPECT was performed 11 weeks after PCI to identify true reversibility on baseline SPECT. Results: The sensitivity, specificity, positive and negative predictive value, and concordance of FFR ≤0.75 for detecting reversibility on SPECT were 88{\%}, 50{\%}, 68{\%}, 89{\%}, and 71{\%} (chi-square",
    author = "Habib Samady and Wolfgang Lepper and Powers, {Eric R.} and Kevin Wei and Michael Ragosta and Bishop, {Gregory G.} and Sarembock, {Ian J.} and Lawrence Gimple and Watson, {Denny D.} and Beller, {George A.} and Barringhaus, {Kurt G.}",
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    AU - Samady, Habib

    AU - Lepper, Wolfgang

    AU - Powers, Eric R.

    AU - Wei, Kevin

    AU - Ragosta, Michael

    AU - Bishop, Gregory G.

    AU - Sarembock, Ian J.

    AU - Gimple, Lawrence

    AU - Watson, Denny D.

    AU - Beller, George A.

    AU - Barringhaus, Kurt G.

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