Valdés BG, Puente BAC, Rosales USG, Rivera BB

Language: Spanish
References: 11
Page: 313-319
PDF size: 285.30 Kb.

ABSTRACT

Introduction: Coronary artery disease (CAD) is a major cause of death and disability. The positron emission tomography (PET) image is today the most useful method in the approach of CAD. The coronary calcium score (CCS) correlates with major cardiovascular events. The addition of studies of myocardial perfusion and coronary calcium score increases its diagnostic sensitivity. Coronary calcium in each artery has not been associated with perfusion defects in their territories, indicating the presence of significant lesions. Objective: To evaluate the correlation between the calcium score of each coronary artery and the perfusion defects in its territory by ¹³N-Ammonium PET-CT. Material and methods: 80 patients in the unit PET-CT of the Faculty of Medicine of the UNAM, City of Mexico, underwent myocardial perfusion study with 13N-ammonia, rest-stress, with adenosine and simple tomography for the quantification of the coronary calcium. They were classified at low risk (0-100 U), Intermediate (100-400 U) and High (400-1,000 U). Regarding the defects in the myocardial perfusion, they were classified in mild, moderate and severe ischemia by coronary territories. Results: Average age: 63 years, 40% women. Risk factors: obesity 21.8%, hypertension 63.6%, dyslipidemia 56.3%, diabetes mellitus 21.8%, smoking 38.18%. Based on the total SCC: 52.7% low risk, of which 75% showed moderate to severe ischemia. The 25.5% intermediate risk, corresponding 80% to moderate to severe ischemia. 21.8% was high risk and of these 78% presented moderate ischemia to severe. Moderate to severe ischemia was detected in the territory of the anterior descending in 27%, circumflex 6% and the right coronary artery at 60%. The correlation with the Pearson coefficient was r = 0.34, with p = 0.0046. Conclusions: There is statistically significant correlation between the coronary calcium of each of the arteries and the defects of perfusion in their territories, we can propose that, even with low-risk CCS, the calcium accumulated in a coronary artery could be predictive of hemodynamic impact in their territory.

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