Comparison of left ventricular myocardial perfusion parameters according to adenosine triphosphate stress computed tomography myocardial perfusion with clinical parameters of patients with nonobstructive coronary artery disease

Aim. To assess the relationship between left ventricular (LV) myocardial perfusion parameters according to adenosine triphosphate (ATP) stress computed tomography myocardial perfusion (CTP) with clinical parameters in patients with non-obstructive coronary artery disease (CAD). Material and methods. ATP CTP was performed in 74 patients with documented non-obstructive CAD. Myocardial perfusion was assessed using qualitative and semiquantitative methods. The volume of myocardial ischemia was assessed depending on the number of segments with perfusion defects. The study protocol included assessment of LV myocardial perfusion at rest and in stress with ATP administration at a constant rate of 0,16 mg/kg/min, for a total duration of 4-5 min. All patients underwent the following examinations: electrocardiography, Holter monitoring, echocardiography, blood tests. The results of myocardial perfusion were compared with age, sex, atherosclerosis risk factors, angina clinical picture, and the results of additional examination methods. Results. Transient LV myocardial perfusion defects were visualized in 100% of patients during ATP CTP with subendocardial location of varying severity. The transmural perfusion coefficient (TPС) was significantly reduced globally and segmentally in the stress phase in all patients (p<0,0001). ST segment depression according to Holter monitoring was associated with a greater LV ischemia volume. When dividing patients into 3 groups depending on the number of affected segments, no significant differences were found according to the intergroup analysis between the LV myocardial ischemia volume and the average values of atherosclerosis risk factors. Conclusion. LV myocardial perfusion defects were detected in 74 patients with an established non-obstructive CAD. No significant differences were found between the LV myocardial ischemia volume and the main risk factors for atherosclerosis, but there was an association between ST segment depression and LV myocardial ischemia volume, a significant decrease in global and segmental TPC with ATP stress test.