Coronary Flow Reserve (CFR) in Cardiovascular Risk Stratification

Study Overview
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Brief Summary
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CFR has been studied for few years using 82 Rubidium PET (positron emission tomography) /CT. CFR has shown to be correlated with cardiovascular events occurring in the 10 following years. CFR also helps to identify multivessel coronary disease. Few studies have shown the possibility to calculate CFR during myocardial perfusion SPECT on new ultrafast CZT cameras.

Detailed Description
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Evaluate the contribution of CZT SPECT CFR in cardiovascular risk stratification: correlation with clinical scores, with calcium score, and when pathological with coronarography findings especially fractional flow reserve (FFR).

Official Title
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SPECT Myocardial Perfusion Reserve Using a Cadmium Zinc Telluride (CZT) Camera in Cardiovascular Risk Stratification and Ischemia

Conditions
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Ischemia, Myocardial, Ischemic Heart Disease

Intervention / Treatment
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* Diagnostic Test: CZT SPECT acquisition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients referred for myocardial ischemia screening Exclusion Criteria: Patient already suffering from coronary disease with angioplasty, bypass surgery or myocardial infarction. Contraindications related to the stress test: Acute Coronary Syndrome <5 days Unstable angina Stenosis of left main artery untreated Uncontrolled severe rhythm disorders Uncontrolled heart failure Contraindications to dipyridamole and regadenoson: Hypotension (systolic <90mmHg) Severe pulmonary arterial hypertension Bradycardia <40 beats / minute Sinusal Dysfunction and 2nd or 3rd degree Atrioventricular block Decompensated Heart Failure with Ejection Fraction <25% Stenosis of supra-aortic trunks unilateral> 70% or bilateral> 50% Dipyridamole and regadenoson allergy Patients with pacemaker, or who have had valvular surgery, Well-known dilated cardiopathy Pregnant or breastfeeding women, Minor people Persons under guardianship or under guardianship

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Patient with myocardial ischemia<br> | Diagnostic Test: CZT SPECT acquisition<br>* CZT SPECT acquisition, with dynamic stress and rest acquisitions to calculate CFR If pathological, coronarography with FFR measurement if necessary In case of intermediate coronary stenosis with medical treatment, SPECT CFR evaluation after one year of treatment<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Regional and global CFR | Regional and global CFR calculated from CZT SPECT myocardial perfusion: correlation with clinical score and calcium score | Day 0 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| FFR Regional CFR after one year of medical treatment | FFR measured during coronarography if there is an intermediate stenosis Regional CFR if there is an intermediate coronary stenosis with medical treatment, after one year of treatment, calculated during a new SPECT CZT exam | Up to one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CFR, SPECT, CZT, Coronary, Calcium score, Scintigraphy, Myocardial perfusion