13N- 氨正电子发射计算机断层显像(PET MPI)显示的一过性缺血扩张对非阻塞性 CAD 患者短期预后的预测价值

IF 2.5 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Annals of Nuclear Medicine Pub Date : 2024-09-09 DOI:10.1007/s12149-024-01976-8
Yanni jia, Yingqi Hu, Lihong Yang, Xin Diao, Yuanyuan Li, Yanhui Wang, Ruonan Wang, Jianbo Cao, Sijin Li
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引用次数: 0

摘要

目的短暂性缺血扩张(TID)在阻塞性冠状动脉疾病(CAD)中具有增量诊断和预后价值,但其在非阻塞性 CAD 患者中的临床意义仍然未知。我们的目的是通过 13N-ammonia PET 成像探讨 TID 在非阻塞性 CAD 患者中的预后价值。方法我们回顾性研究了 131 例连续接受一天静息负荷 13N-ammonia PET 心肌灌注成像(MPI)的非阻塞性 CAD 患者。TID由CardIQ Physio软件自动生成。采用接收者操作特征曲线(ROC)确定 TID 的最佳阈值。随访结果为主要心脏不良事件(MACE),即心力衰竭或不稳定型心绞痛再住院、晚期血管重建、非致命性心肌梗死和心源性死亡的综合结果。结果在中位随访 42.08 ± 17.67 个月期间,22 例(16.7%)患者发生了 MACE。根据 MACE,TID 的最佳临界值为 1.03。我们的初步结果分析表明,TID 正常的受试者总生存概率较低。此外,我们的多变量分析表明,TID 异常是非阻塞性 CAD 患者发生 MACE 的唯一独立预测因素。结论在非梗阻性 CAD 患者中,PET 导出的 TID ≥ 1.03 可独立识别出随后发生 MACE 的高风险人群。图形摘要 CAD 冠状动脉疾病;PET 正电子发射断层扫描;MPI 心肌灌注成像;TID 短暂性缺血扩张;MACE 主要心脏不良事件;ROC 受体操作特征。
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Prognostic value of transient ischemic dilatation by 13N-ammonia PET MPI for short-term outcomes in patients with non-obstructive CAD

Objective

Transient ischaemic dilatation (TID) had incremental diagnostic and prognostic value in obstructive coronary artery disease (CAD), but its clinical significance in patients with non-obstructive CAD remains unknown. We aimed to explore the prognostic value of TID in patients with non-obstructive CAD by 13N-ammonia PET imaging.

Methods

We retrospectively studied 131 consecutive patients with non-obstructive CAD undergoing one-day rest-stress 13N-ammonia PET myocardial perfusion imaging (MPI). TID was automatically generated using CardIQ Physio software. The receiver operative characteristic (ROC) curve was used to determine the optimal threshold of TID. The follow-up outcome was major adverse cardiac events (MACE), a composite of re-hospitalization for heart failure or unstable angina, late revascularization, non-fatal myocardial infarction, and cardiac death. Cardiac event-free survivals for normal and abnormal TID were compared using Kaplan–Meier plots and log-rank tests.

Results

During a median follow-up of 42.08 ± 17.67 months, 22 (16.7%) patients occurred MACE. The optimal cut-off value of TID was 1.03 based on MACE. Our preliminary outcome analysis suggests that TID-abnormal subjects had a lower overall survival probability. Furthermore, our multivariate analysis reveals abnormal TID was the only independent predictor for MACE in non-obstructive CAD. In the subgroup analysis, an abnormal TID was an independent predictor for MACE in patients with abnormal perfusion patterns.

Conclusion

Among patients with non-obstructive CAD, PET-derived TID ≥ 1.03 may identify those with a high risk of subsequent MACE independently. It was also an independent risk factor for poor prognosis in patients with abnormal perfusion.

Graphical abstract

CAD coronary artery disease, PET positron emission tomography, MPI myocardial perfusion imaging, TID transient ischaemic dilatation, MACE major adverse cardiac events, ROC receiver operative characteristic.

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来源期刊
Annals of Nuclear Medicine
Annals of Nuclear Medicine 医学-核医学
CiteScore
4.90
自引率
7.70%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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