所属 医学部 医学科（東京女子医科大学病院） 職種 教授
|発表タイトル||13N Ammonia PET Myocardial Flow Reserve for Detection of Cardiac Allograft Vasculopathy in Heart Transplant Patients|
|会議名||The 83rd Annual Scientific Meeting of the Japanese Circulation Society (JCS2019)|
|主催者||Japanese Circulation Society|
|発表者・共同発表者||◎YAMAMOTO Eri, KIKUCHI Noriko, NAGAO Michinobu, MOMOSE Mitsuru, HATTORI Hidetoshi, SUZUKI Atsushi, SHIGA Tsuyoshi, WATANABE Eri, ICHIHARA Yuki, KOMAGAMINE Masahide, NISHINAKA Tomohiro, SAITO Satoshi, NIINAMI Hiroshi, HAGIWARA Nobuhisa, NUNODA Shinichi|
|概要||*Oral Presentation (English) 24 Nuclear Imaging
Purpose: Risk stratification and early detection of cardiac allograft vasculopathy (CAV) is essential in heart transplantation patients. CAV often presents a diffuse vascular pattern, and has been difficult to diagnose noninvasively by the lack of a sensitive method to detect developing vascular pathology in the allograft. The present study investigates the ability of 13N-ammonia PET for detection of CAV in heart plant patients. Methods: Data of adenosine-stress 13N-ammonia PET imaging for twenty-seven patients (mean age, 38 years-old) after 11 ± 8 years after heart transplant was analyzed. Five patients had underwood percutaneous coronary intervention (PCI) for CAV. The other 22 patients had no history of myocardial ischemia. Myocardial flow was generated from the time activity curve of left ventricle input and myocardial uptake using 3-compartment model and the first 2 minutes´ dataset of list-mode acquisition. GlobalMFR was calculated by stress to rest flow ratio. Patient with Global-MFR < 2.0 was defined as significant decrease in MFR. Summed difference score (SDS) was used as an estimate of the extent of ischemia. Patient with SDS > 2 was identified as significant ischemia. Results: The mean GlobalMFR were 2.3 (1.2 to 3.9). Nine patients with Global-MFR <2.0 (33%) were observed, and six of them had no history of ischemia. There were six patients with SDS > 2 (22%) including three patients after PCI. Conclusion: 13N-ammonia PET MFR significantly decreases in about one third heart transplant patients, and is a candidate for early detection of CAV in asymptomatic patients.