Absolute quantitation of coronary steal induced by intravenous dipyridamole
Olakunle O. Akinboboye, MD, MPH, FACC*,
Olajide Idris, MD ,
Ru-Ling Chou, PhD,
Robert R. Sciacca, EngScD,
Paul J. Cannon, MD, FACC and
Steven R. Bergmann, MD, PhD, FACC
* Nuclear Cardiology Laboratory, St. Francis Hospital, Roslyn, New York, USA
Division of Cardiology, College of Physicians and Surgeons of Columbia University, New York, New York, USA
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Figure 1 Parametric polar map of myocardial perfusion at rest (left), after coronary vasodilation with dipyridamole (middle), and a map of myocardial perfusion reserve (produced by a pixel-by-pixel division of the post-dipyridamole map by the resting map) in a patient with coronary steal (A) and a patient without coronary steal (B). The color scale represents absolute myocardial perfusion (ml/100 g/min) in the flow map, and a relative ratio in the map of myocardial perfusion reserve. Blood flow in the patient with steal decreases in absolute terms after dipyridamole, and myocardial perfusion reserve becomes <1. Polar maps represent myocardial perfusion with anterior to the top, lateral to the reader’s right, inferior myocardium to the bottom, and septal myocardium to the reader’s left. The apex is depicted in the center and the base at the periphery.
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Figure 2 Histogram of myocardial perfusion in hearts from patients who exhibited steal in at least one segment. In these patients, as depicted, myocardial perfusion at rest in segments with and without steal was equivalent. However, after dipyridamole, segments with steal exhibited an absolute reduction in perfusion, whereas segments without steal vasodilated to similar levels as those observed in patients without steal. Open bars: segments with steal (n = 24); solid bars: segments without steal (n = 40).
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