Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction

Fig. 1. Flow chart of patient inclusion and exclusion. CT = computed tomography, MPI = myocardial perfusion imaging, STEMI = ST-segment elevated myocardial infarction

Fig. 2. Representative case of severely reduced MBF and high peak hs-TnT level in 62-year-old male STEMI patient. A. ICA showed occlusion of proximal LAD (arrow). B. PCI was performed to restore patency to lumen (arrow). C. Color-coded fusion image of short-axis view derived from dynamic CT-MPI showed dramatically reduced MBF of middle anterior and middle anteroseptal segment (mean MBF = 21 mL/100 mL/min) (arrows). Mean MBF of reference territory was 68 mL/100 mL/min. Peak hs-TnT level was 32.6 µg/L. hs-TnT = high-sensitivity troponin T, ICA = invasive coronary angiography, LAD = left anterior descending artery, MBF = myocardial blood flow, PCI = percutaneous coronary intervention

Fig. 3. Representative case of mildly reduced MBF and low peak hs-TnT level in 67-year-old male STEMI patient. A. ICA showed occlusion of distal RCA (arrow). B. PCI was performed to restore patency to lumen (arrow). C. Color-coded fusion image of short-axis view derived from dynamic CT-MPI showed mildly reduced MBF of mid inferior segment (mean MBF = 45 mL/100 mL/min) (arrows). Mean MBF of reference territory was 74 mL/100 mL/min. Peak hs-TnT level was 5.4 µg/L. RCA = right coronary artery

Fig. 4. Correlation of peak hs-TnT level and LVEF (at time of admission and at 6 months) with MBF and MBFinfarct/MBFreference. Both MBF and MBFinfarct/MBFreference were shown to inversely correlate with peak hs-TnT level and proportionally correlate with LVEF. LVEF = left ventricular ejection fraction