Risk Stratification Using Right Ventricular Longitudinal Strain Ratio Derived from 13N-Ammonia PET in Patients with Ischemic Heart Disease.
Atsushi Yamamoto, Michinobu Nagao, Masateru Kawakubo, Risako Nakao, Yuka Matsuo, Akiko Sakai, Koichiro Kaneko, Kenji Fukushima, Mitsuru Momose, Shuji Sakai, Junichi Yamaguchi
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引用次数: 0
Abstract
Purpose To investigate whether right ventricular (RV) myocardial strain ratio (RVMSR) assessed using nitrogen 13 ammonia (13N-NH3) PET can predict cardiovascular events in patients with ischemic heart disease (IHD). Materials and Methods This retrospective study included 480 consecutive patients (mean age, 66 years ± 12 [SD]; 334 males and 146 females) with IHD who underwent 13N-NH3 PET. RVMSR was defined as the ratio of RV strain during stress to that at rest. The primary end point was major adverse cardiac events (MACEs), defined as cardiac death or heart failure hospitalization. The ability of RVMSR to predict MACE was assessed using receiver operating characteristic (ROC) curve and Kaplan-Meier analyses. Cox proportional hazards regression analysis was used to calculate hazard ratios (HRs) with 95% CIs. Results ROC curve analysis identified a sensitivity and specificity of 84% and 82%, respectively, for predicting MACE from RVMSR. Patients with reduced RVMSR (<110.2) displayed a significantly higher rate of MACE than those with a preserved RVMSR (34 of 240 vs four of 240; P < .001). Cox proportional hazards regression analysis of imaging parameters, including myocardial flow reserve, indicated that RVMSR was an independent predictor of MACE (HR, 0.94 [95% CI: 0.92, 0.97]; P < .001). Conclusion RVMSR was an independent predictor of MACE and has potential to aid in the risk stratification of patients with IHD. Keywords: Right Ventricular Myocardial Strain Ratio, Myocardial Flow Reserve, Ischemic Heart Disease, 13N-Ammonia Positron Emission Tomography Supplemental material is available for this article. © RSNA, 2024.
利用 13N-Ammonia PET 得出的缺血性心脏病患者右心室纵向应变比进行风险分层
目的 探讨使用氮13氨(13N-NH3)PET评估的右心室(RV)心肌应变比(RVMSR)能否预测缺血性心脏病(IHD)患者的心血管事件。材料和方法 这项回顾性研究纳入了 480 名连续接受 13N-NH3 PET 检查的 IHD 患者(平均年龄为 66 岁 ± 12 [SD];男性 334 人,女性 146 人)。RVMSR 被定义为应激时 RV 应变与静息时 RV 应变的比值。主要终点是主要心脏不良事件(MACE),即心源性死亡或心衰住院。采用接收器操作特征曲线(ROC)和卡普兰-梅耶分析评估了 RVMSR 预测 MACE 的能力。Cox 比例危险回归分析用于计算危险比 (HR) 及 95% CI。结果 ROC 曲线分析表明,根据 RVMSR 预测 MACE 的灵敏度和特异度分别为 84% 和 82%。RVMSR降低的患者(P < .001)。对包括心肌血流储备在内的成像参数进行的 Cox 比例危险回归分析表明,RVMSR 是 MACE 的独立预测因子(HR,0.94 [95% CI:0.92, 0.97];P < .001)。结论 RVMSR是MACE的独立预测因子,具有帮助对IHD患者进行风险分层的潜力。关键词右心室心肌应变比 心肌血流储备 缺血性心脏病 13N-氨正电子发射断层扫描 本文有补充材料。© RSNA, 2024.
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