TY - JOUR
T1 - Analysis of myocardial perfusion parameters in an ex-vivo porcine heart model using third generation dual-source CT
AU - Pelgrim, Gert Jan
AU - Duguay, Taylor M.
AU - Stijnen, J. Marco A.
AU - Varga-Szemes, Akos
AU - Van Tuijl, Sjoerd
AU - Schoepf, U. Joseph
AU - Oudkerk, Matthijs
AU - Vliegenthart, Rozemarijn
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Purpose To evaluate the relationship between fractional flow reserve (FFR)-determined coronary artery stenosis severity and myocardial perfusion parameters derived from dynamic myocardial CT perfusion imaging (CTP) in an ex-vivo porcine heart model. Methods Six porcine hearts were perfused according to Langendorff. Circulatory parameters such as arterial blood flow (ABF) (L/min), mean arterial pressure (MAP) (mmHg) and heart rate (bpm) were monitored. Using an inflatable cuff and monitored via a pressure wire, coronary artery stenoses of different FFR grades were created (no stenosis, FFR = 0.80, FFR = 0.70, FFR = 0.60, and FFR = 0.50). Third generation dual-source CT was used to perform dynamic CTP in shuttle mode at 70 kV. Using the AHA-16-segment model, myocardial blood flow (MBF) (mL/100 mL/min) and volume (MBV) (mL/100 mL) were analyzed using dedicated software for all ischaemic and non-ischaemic segments. Results During five successful experiments, ABF ranged from 0.8 to 1.2 L/min, MAP from 73 to 90 mmHg and heart rate from 83 to 115 bpm. Non-ischaemic and ischaemic segments showed significant differences in MBF for stenosis grades of FFR ≤ 0.70. At this degree of obstruction, median MBF was 79 (interquartile range [IQR]: 66–90) for non-ischaemic segments versus 56 mL/100 mL/min (IQR: 46–73) for ischaemic segments (p < 0.05). For MBV, a significant difference was found at FFR ≤ 0.80 with median MBV values of 7.6 (IQR: 7.0–8.3) and 7.1 mL/100 mL (IQR: 6.0–8.2) for non-ischaemic and ischaemic myocardial segments, respectively (p < 0.05). Conclusion Artificial flow alterations in a Langendorff porcine heart model could be detected and measured by CTP-derived myocardial perfusion parameters and showed significant systematic correlation with stepwise flow reduction that permitted early detection of ischaemic myocardium. Additional research in clinical setting is required to develop absolute quantitative CTP.
AB - Purpose To evaluate the relationship between fractional flow reserve (FFR)-determined coronary artery stenosis severity and myocardial perfusion parameters derived from dynamic myocardial CT perfusion imaging (CTP) in an ex-vivo porcine heart model. Methods Six porcine hearts were perfused according to Langendorff. Circulatory parameters such as arterial blood flow (ABF) (L/min), mean arterial pressure (MAP) (mmHg) and heart rate (bpm) were monitored. Using an inflatable cuff and monitored via a pressure wire, coronary artery stenoses of different FFR grades were created (no stenosis, FFR = 0.80, FFR = 0.70, FFR = 0.60, and FFR = 0.50). Third generation dual-source CT was used to perform dynamic CTP in shuttle mode at 70 kV. Using the AHA-16-segment model, myocardial blood flow (MBF) (mL/100 mL/min) and volume (MBV) (mL/100 mL) were analyzed using dedicated software for all ischaemic and non-ischaemic segments. Results During five successful experiments, ABF ranged from 0.8 to 1.2 L/min, MAP from 73 to 90 mmHg and heart rate from 83 to 115 bpm. Non-ischaemic and ischaemic segments showed significant differences in MBF for stenosis grades of FFR ≤ 0.70. At this degree of obstruction, median MBF was 79 (interquartile range [IQR]: 66–90) for non-ischaemic segments versus 56 mL/100 mL/min (IQR: 46–73) for ischaemic segments (p < 0.05). For MBV, a significant difference was found at FFR ≤ 0.80 with median MBV values of 7.6 (IQR: 7.0–8.3) and 7.1 mL/100 mL (IQR: 6.0–8.2) for non-ischaemic and ischaemic myocardial segments, respectively (p < 0.05). Conclusion Artificial flow alterations in a Langendorff porcine heart model could be detected and measured by CTP-derived myocardial perfusion parameters and showed significant systematic correlation with stepwise flow reduction that permitted early detection of ischaemic myocardium. Additional research in clinical setting is required to develop absolute quantitative CTP.
KW - Animal model
KW - Iodine
KW - Ischemia
KW - Myocardial perfusion imaging
KW - Tomography
KW - X-ray computed
UR - http://www.scopus.com/inward/record.url?scp=85011983810&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2017.01.012
DO - 10.1016/j.jcct.2017.01.012
M3 - Article
C2 - 28202246
AN - SCOPUS:85011983810
SN - 1934-5925
VL - 11
SP - 141
EP - 147
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
IS - 2
ER -