Evaluation of left ventricular myocardial perfusion using volumetric computed tomography with adenosine triphosphate test in patients with non-obstructive coronary artery disease during drug therapy

Aim. To study the potential of assessing left ventricular (LV) myocardial perfusion using volumetric computed tomography (VCT) with adenosine triphosphate (ATP) test in patients with non-obstructive coronary artery disease (NOCAD) during combined therapy. Material and methods. Cardiac VCT with ATP test, combined with computed coronary angiography, was performed in 46 patients with an established diagnosis of NOCAD. At the time of enrollment, all patients were recommended lipid-lowering therapy to achieve target lipid profile parameters, antianginal and antithrombotic therapy. Results. Changes of LV myocardial perfusion parameters depending on achievement of target low-density lipoprotein cholesterol (LDL-C) demonstrates reliable decrease in the number of LV myocardial segments with perfusion defects (2 [0; 3] vs 6 [3; 8], p<0,001) and increase in transmural perfusion coefficient (TPC) in the stress phase (1,14±0,12 vs 1,02±0,07, p=0,004). Moderate negative correlation was revealed in patients with NOCAD between the mean TPC value in the stress phase and LDL-C level (n=45, rho=-0,56; p=0,001). Significant improvement of LV myocardial perfusion was demonstrated among patients receiving combination therapy. Conclusion. Combination therapy is significantly associated with improved LV myocardial perfusion parameters. When the target LDL-C level is reached, it is accompanied by a significant TPC increase and a decrease in the number of segments with perfusion defects in patients with NOCAD according to VCT with an ATP test.