Added prognostic value of myocardial blood flow quantitation in rubidium-82 positron emission tomography imaging.

Details

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State: Public
Version: Final published version
Serval ID
serval:BIB_9B3DA73CAA5B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Added prognostic value of myocardial blood flow quantitation in rubidium-82 positron emission tomography imaging.
Journal
European heart journal cardiovascular Imaging
Author(s)
Farhad H., Dunet V., Bachelard K., Allenbach G., Kaufmann P.A., Prior J.O.
ISSN
2047-2412 (Electronic)
ISSN-L
2047-2404
Publication state
Published
Issued date
12/2013
Peer-reviewed
Oui
Volume
14
Number
12
Pages
1203-1210
Language
english
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
We studied the respective added value of the quantitative myocardial blood flow (MBF) and the myocardial flow reserve (MFR) as assessed with (82)Rb positron emission tomography (PET)/CT in predicting major adverse cardiovascular events (MACEs) in patients with suspected myocardial ischaemia.
Myocardial perfusion images were analysed semi-quantitatively (SDS, summed difference score) and quantitatively (MBF, MFR) in 351 patients. Follow-up was completed in 335 patients and annualized MACE (cardiac death, myocardial infarction, revascularization, or hospitalization for congestive heart failure or de novo stable angor) rates were analysed with the Kaplan-Meier method in 318 patients after excluding 17 patients with early revascularizations (<60 days). Independent predictors of MACEs were identified by multivariate analysis. During a median follow-up of 624 days (inter-quartile range 540-697), 35 MACEs occurred. An annualized MACE rate was higher in patients with ischaemia (SDS >2) (n = 105) than those without [14% (95% CI = 9.1-22%) vs. 4.5% (2.7-7.4%), P < 0.0001]. The lowest MFR tertile group (MFR <1.8) had the highest MACE rate [16% (11-25%) vs. 2.9% (1.2-7.0%) and 4.3% (2.1-9.0%), P < 0.0001]. Similarly, the lowest stress MBF tertile group (MBF <1.8 mL/min/g) had the highest MACE rate [14% (9.2-22%) vs. 7.3% (4.2-13%) and 1.8% (0.6-5.5%), P = 0.0005]. Quantitation with stress MBF or MFR had a significant independent prognostic power in addition to semi-quantitative findings. The largest added value was conferred by combining stress MBF to SDS. This holds true even for patients without ischaemia.
Perfusion findings in (82)Rb PET/CT are strong MACE outcome predictors. MBF quantification has an added value allowing further risk stratification in patients with normal and abnormal perfusion images.

Keywords
Aged, Cohort Studies, Coronary Artery Disease/diagnosis, Coronary Artery Disease/diagnostic imaging, Coronary Circulation/physiology, Disease Progression, Evaluation Studies as Topic, Female, Humans, Image Enhancement, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction/diagnosis, Myocardial Infarction/diagnostic imaging, Myocardial Ischemia/diagnosis, Myocardial Ischemia/diagnostic imaging, Myocardial Perfusion Imaging/methods, Positron-Emission Tomography/methods, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Prospective Studies, Rubidium Radioisotopes, Severity of Illness Index, Statistics, Nonparametric, Tomography, X-Ray Computed/methods, Coronary artery disease, Major adverse cardiovascular events, Myocardial perfusion imaging, Outcome, Positron emission tomography, Rubidium-82
Pubmed
Web of science
Open Access
Yes
Create date
15/12/2013 15:46
Last modification date
20/08/2019 15:02
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