AUTHOR=Yan Ming , Shang Hua , Guo Xiaorui , Hao Luping , Hou Shuang , Zheng Hongming 

TITLE=The diagnostic role of resting myocardial blood flow in STEMI patients after revascularization

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1364772

DOI=10.3389/fcvm.2024.1364772

ISSN=2297-055X

ABSTRACT=Background
The value of semi-quantitative resting myocardial perfusion imaging (resting MPI) in coronary artery disease (CAD) is limited. At present, quantitative MPI can be performed by a new cadmium zinc tellurium single photon emission computed tomography (CZT-SPECT). The quantitative index of resting myocardial blood flow (resting MBF) has received little attention, and its manifestations and clinical value in the presence of unstable coronary blood flow have not been clarified.
Purpose 
In ST-segment elevation myocardial infarction (STEMI), compared to semi-quantitative resting MPI whether resting MBF can provide additional value. We also explored the influencing factors of resting MBF.
Methods
This was a retrospective clinical study. We included 75 patients with STEMI in the subacute phase who underwent resting MPI and dynamic scans after reperfusion therapy. General patient information, STEMI-related data, MPI, gated MPI (G-MPI), resting MBF data were collected and recorded. According to the clinically provided culprit vessels, the resting MBF was divided into ischemic MBF and non-ischemic MBF. The paired Wilcoxon signed-rank test was used for resting MBF. The receiver operating characteristic (ROC) curves were used to determine the optimal threshold for ischemia, and multiple linear regression analysis was used to analyse the influencing factors of resting MBF.
Results
There was a statistically significant difference between the ischemic MBF and non-ischemic MBF (0.59 [0.47-0.72 ]vs 0.76 [0.64-0.93], P<0.0001). The ROC curve analysis revealed that resting MBF could identify ischemia to a certain extent, with a cut-off value of 0.5975, area under caver (AUC)=0.666, sensitivity=55.8%, and specificity=68.7%. Male sex and summed rest score (SRS) were influencing factors for resting MBF.
Conclusion
To a certain extent, resting MBF can suggest residual ischemia after reperfusion therapy in patients with STEMI. There was a negative correlation between male sex, SRS and ischemic MBF. A lower resting MBF may be associated with more severe myocardial ischemia.