{
  "abstract": "A characteristic feature of obstructive coronary artery disease (CAD) is impaired myocardial blood flow (MBF). Previous studies have shown that atrial fibrillation (AF) is also associated with reduced hyperemic MBF. However, it is unknown whether an independent association exists between AF and MBF in symptomatic patients with suspected obstructive CAD. We studied 874 patients at Kuopio University Hospital (Finland) who underwent coronary computed tomography angiography (CCTA) and [15O]H2O myocardial perfusion positron emission tomography due to suspected obstructive CAD in 2017–2023. The final cohort comprised 31 AF patients and 120 propensity score-matched sinus rhythm (SR) patients. The matching criteria were age, sex, body mass index, number of traditional risk factors for CAD (0–5), calcium score, and total CCTA status (i.e., the overall severity of CCTA findings). Global hyperemic MBF was lower in AF patients than in SR patients (median 1.9 mL/g/min [IQR 1.4–2.6 mL/g/min] vs. 3.0 mL/g/min [IQR 2.4–3.6 mL/g/min], p < 0.001). Impaired hyperemic MBF (< 2.3 mL/g/min in ≥ 1 segment) was more frequent in AF patients (n = 25/31, 81%) than in SR patients (n = 50/120, 42%, p < 0.001). Furthermore, the presence of AF was independently associated with reduced hyperemic MBF in three multivariate general linear models (p < 0.001 in each model). To summarize, AF was independently associated with impaired hyperemic MBF in patients with suspected obstructive CAD. This association should be considered in clinical practice when interpreting the results of myocardial perfusion imaging in patients with AF.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, North Savo, Finland",
    "Institute of Clinical Medicine, University of Eastern Finland, Kuopio, North Savo, Finland",
    "Helsinki Sports and Exercise Medicine Clinic (HULA), Foundation for Sports and Exercise Medicine, Helsinki, Uusimaa, Finland",
    "Sports and Exercise Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Uusimaa, Finland",
    "Department of Medicine, Kuopio University Hospital, Kuopio, North Savo, Finland",
    "Department of Clinical Radiology, Kuopio University Hospital, Kuopio, North Savo, Finland",
    "A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, North Savo, Finland",
    "Heart Center, Kuopio University Hospital, Kuopio, North Savo, Finland",
    "Gene Therapy Unit, Kuopio University Hospital, Kuopio, North Savo, Finland",
    "Department of Clinical Physiology and Nuclear Medicine, Mikkeli Central Hospital, Mikkeli, South Savo, Finland",
    "Department of Clinical Physiology and Nuclear Medicine, North Karelia Central Hospital, Joensuu, North Karelia, Finland"
  ],
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        0
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      "orcid": "0000-0002-6721-1166"
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        0,
        1
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      "name": "Suvi Hartikainen",
      "orcid": "0000-0001-7718-5144"
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    {
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        3,
        4
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      "name": "Antti-Pekka E. Rissanen",
      "orcid": "0000-0003-2415-3979"
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    {
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        0,
        5
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      "name": "Elina Kariniemi",
      "orcid": "0009-0008-1935-2635"
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    {
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        7,
        8
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      "name": "Aleksi J. Leikas",
      "orcid": "0000-0001-9590-0105"
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      "name": "Eero Strengell"
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    {
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      "name": "Svantte Halttunen"
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      "name": "Paavo-Ilari Kuikka"
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    {
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        7,
        8
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      "name": "Juha E. K. Hartikainen",
      "orcid": "0000-0003-0847-107X"
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    {
      "affs": [
        0,
        1
      ],
      "name": "Tomi P. Laitinen"
    }
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  "title": "Atrial fibrillation is independently associated with impaired myocardial perfusion",
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