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

Farhad, Hoshang ; Dunet, Vincent ; Bachelard, Kim ; Allenbach, Gilles ; Kaufmann, Philipp A ; Prior, John O

European heart journal cardiovascular imaging, 2013-12, Vol.14 (12), p.1203-1210 [Periódico revisado por pares]

England

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Título:
Added prognostic value of myocardial blood flow quantitation in rubidium-82 positron emission tomography imaging
Autor: Farhad, Hoshang ; Dunet, Vincent ; Bachelard, Kim ; Allenbach, Gilles ; Kaufmann, Philipp A ; Prior, John O
Assuntos: 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
É parte de: European heart journal cardiovascular imaging, 2013-12, Vol.14 (12), p.1203-1210
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: 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.
Editor: England
Idioma: Inglês

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

Farhad, Hoshang ; Dunet, Vincent ; Bachelard, Kim ; Allenbach, Gilles ; Kaufmann, Philipp A ; Prior, John O

England

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