Krishna K Patel, Phillip Lim, Poghni A Peri-Okonny, Annapoorna Singh, A Iain McGhie, Basera Sabharwal, Vikram Agarwal, Leslee J Shaw, Timothy M Bateman
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引用次数: 0
Abstract
Rationale: Transient ischemic dilation (TID) of the left ventricular (LV) cavity is considered a high-risk marker in patients with abnormal single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Stress image acquisition in Rubidium-82 (82Rb) PET occurs at peak stress compared to 30-60 minutes post stress with SPECT. We aimed to evaluate the prognostic value of TID among patients undergoing 82Rb PET MPI.
Methods: A total of 9878 consecutive patients with LVEF ≥40% undergoing rest/pharmacologic stress 82Rb PET MPI from 2010-2016 were followed for a median of 3.2 years. The primary clinical outcome of cardiac death was assessed after adjusting for pre-test risk, known coronary artery disease (CAD), rest left ventricular ejection fraction (LVEF), summed stress score (SSS), LVEF reserve (LVEF-R), myocardial blood flow reserve (MBFR) and early (90-day) revascularization. Pre-specified interactions between TID ratio and SSSwere included to assess potential differences in the prognostic value of TID in patients based on perfusion.
Results: Mean age of the cohort was 69.0 (11.7) years, 56.1% female, 49.8% with known CAD, 27.9% with abnormal perfusion (SSS>0).There were 451 cardiac deaths. Higher TID ratio was associated with a significantly higher risk of cardiac death, even after accounting for LVEF-R and MBFR (HR per 0.1 unit increase =1.25 (1.11, 1.41), p<0.001). This was seen both among patients with normal (HR for TID per 0.1 unit increase= 1.24 (95% CI: 1.01, 1.52), p=0.04) and abnormal (HR for TID per 0.1 unit increase= 1.14 (95% CI: 1.02, 1.28), p=0.03) perfusion.
Conclusion: TID on rest/stress 82RbPET MPI offers independent prognostic value in patients with both normal and abnormal perfusion beyond other risk markers, among patients with LVEF >40%.
期刊介绍：
Journal of Nuclear Cardiology is the only journal in the world devoted to this dynamic and growing subspecialty. Physicians and technologists value the Journal not only for its peer-reviewed articles, but also for its timely discussions about the current and future role of nuclear cardiology. Original articles address all aspects of nuclear cardiology, including interpretation, diagnosis, imaging equipment, and use of radiopharmaceuticals. As the official publication of the American Society of Nuclear Cardiology, the Journal also brings readers the latest information emerging from the Society''s task forces and publishes guidelines and position papers as they are adopted.
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