Duration of adenosine-induced myocardial hyperaemia: insights from quantitative 13N-ammonia positron emission tomography myocardial perfusion imaging
Authors' conclusion
Intravenously applied adenosine induces a long-lasting hyperaemic effect on the myocardium.
Study context
- Population
- Patients with suspected chronic coronary syndrome undergoing 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI), with no perfusion defects
- Participants
- 331 patients
- Exposure
- Rapid stress-rest vs rest-stress 13N-ammonia PET MPI protocol
- Stress-restn = 146
- Rest-stressn = 185reference
- Outcome
- Quantitative myocardial blood flow (MBF) at rest (rMBF), adenosine stress MBF (sMBF) and myocardial flow reserve (MFR)
Main finding
As reported in the abstract
rMBF, sMBF and MFR
| Group | rMBF | sMBF | Myocardial flow reserve (MFR) |
|---|---|---|---|
| Stress-rest | 0.80 (interquartile range 0.66-1.00) mL·min-1·g-1 | 2.52 (2.20-2.96) | 3.07 (2.43-3.88) |
| Rest-stress | 0.70 (0.58-0.83) mL·min-1·g-1 | 2.50 (1.96-3.11) | 3.50 (2.63-4.10) |
rMBF
Stress-rest0.80 (interquartile range 0.66-1.00) mL·min-1·g-1
Rest-stress0.70 (0.58-0.83) mL·min-1·g-1
sMBF
Stress-rest2.52 (2.20-2.96)
Rest-stress2.50 (1.96-3.11)
Myocardial flow reserve (MFR)
Stress-rest3.07 (2.43-3.88)
Rest-stress3.50 (2.63-4.10)
- Stress-rest vs Rest-stress: P < 0.001 — rMBF higher with stress-rest
- Stress-rest vs Rest-stress: P = 0.347 — sMBF identical
- Stress-rest vs Rest-stress: P = 0.007 — MFR lower with stress-rest
Observational data: associations, not effects.
Further findings
Correlation of Δtstress-rest with rMBF and MFR (stress-rest)
- Δtstress-rest vs rMBF, r
- −0.259 (P = 0.002)
- Δtstress-rest vs MFR, r
- 0.163 (P = 0.049)
- Proportion with abnormally high rMBF significantly decreased with increasing Δtstress-rest
- Weak correlation
Original publication
Duration of adenosine-induced myocardial hyperaemia: insights from quantitative 13N-ammonia positron emission tomography myocardial perfusion imaging. Eur Heart J Cardiovasc Imaging. Published 8 April 2024. doi:10.
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