Prognostic implications of myocardial perfusion imaging by 82-rubidium positron emission tomography in male and female patients with angina and no perfusion defects
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Prognostic implications of myocardial perfusion imaging by 82-rubidium positron emission tomography in male and female patients with angina and no perfusion defects. / Rauf, Maira; Hansen, Kim W.; Galatius, Søren; Wiinberg, Niels; Brinth, Louise Scouborg; Højstrup, Signe; Talleruphuus, Ulrik; Prescott, Eva.
I: European Heart Journal Cardiovascular Imaging, Bind 24, Nr. 2, 2023, s. 212-222.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Prognostic implications of myocardial perfusion imaging by 82-rubidium positron emission tomography in male and female patients with angina and no perfusion defects
AU - Rauf, Maira
AU - Hansen, Kim W.
AU - Galatius, Søren
AU - Wiinberg, Niels
AU - Brinth, Louise Scouborg
AU - Højstrup, Signe
AU - Talleruphuus, Ulrik
AU - Prescott, Eva
N1 - Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Aims Myocardial perfusion imaging with 82-rubidium positron emission tomography (82Rb-PET) is increasingly used to assess stable coronary artery disease (CAD). We aimed to evaluate the prognostic value of82Rb-PET-derived parameters in patients with symptoms suggestive of CAD but no significant reversible or irreversible perfusion defects. Methods and results Among 3726 consecutive patients suspected of stable CAD who underwent82Rb-PET between January 2018 and August 2020, 2175 had no regional perfusion defects. Among these patients, we studied the association of82Rb-PET-derived parameters with a composite endpoint of all-cause mortality, hospitalization for unstable angina pectoris, acute myocardial infarction, heart failure, or ischaemic stroke. During a median follow up of 1.7 years (interquartile range 1.1–2.5 years), there were 148 endpoints. Myocardial blood flow (MBF) reserve (MFR), MBF during stress, left ventricular ejection fraction (LVEF), LVEF-reserve, heart rate reserve, and Ca score were associated with adverse outcomes. In multivariable Cox model adjusted for patient and82Rb-PET characteristics, MFR < 2 (hazard ratio (HR) 1.75, 95% confidence interval (CI) 1.24–2.48), LVEF (HR 1.38 per 10% decrease, 95% CI 1.24–1.54), and LVEF-reserve (HR 1.19 per 5% decrease, 95% CI 1.07–1.31) were significant predictors of endpoints. Results were consistent in subgroups defined by gender, history of ischaemic heart disease, low LVEF, and atrial fibrillation. Conclusion MFR, LVEF, and LVEF-reserve derived from82Rb-PET provide prognostic information on cardiovascular outcomes in patients with no perfusion defects. This may aid in identifying patients at risk and might provide an opportunity for preventive interventions.
AB - Aims Myocardial perfusion imaging with 82-rubidium positron emission tomography (82Rb-PET) is increasingly used to assess stable coronary artery disease (CAD). We aimed to evaluate the prognostic value of82Rb-PET-derived parameters in patients with symptoms suggestive of CAD but no significant reversible or irreversible perfusion defects. Methods and results Among 3726 consecutive patients suspected of stable CAD who underwent82Rb-PET between January 2018 and August 2020, 2175 had no regional perfusion defects. Among these patients, we studied the association of82Rb-PET-derived parameters with a composite endpoint of all-cause mortality, hospitalization for unstable angina pectoris, acute myocardial infarction, heart failure, or ischaemic stroke. During a median follow up of 1.7 years (interquartile range 1.1–2.5 years), there were 148 endpoints. Myocardial blood flow (MBF) reserve (MFR), MBF during stress, left ventricular ejection fraction (LVEF), LVEF-reserve, heart rate reserve, and Ca score were associated with adverse outcomes. In multivariable Cox model adjusted for patient and82Rb-PET characteristics, MFR < 2 (hazard ratio (HR) 1.75, 95% confidence interval (CI) 1.24–2.48), LVEF (HR 1.38 per 10% decrease, 95% CI 1.24–1.54), and LVEF-reserve (HR 1.19 per 5% decrease, 95% CI 1.07–1.31) were significant predictors of endpoints. Results were consistent in subgroups defined by gender, history of ischaemic heart disease, low LVEF, and atrial fibrillation. Conclusion MFR, LVEF, and LVEF-reserve derived from82Rb-PET provide prognostic information on cardiovascular outcomes in patients with no perfusion defects. This may aid in identifying patients at risk and might provide an opportunity for preventive interventions.
KW - coronary microvascular dysfunction
KW - INOCA
KW - myocardial blood flow reserve
KW - positron emission tomography
U2 - 10.1093/ehjci/jeac217
DO - 10.1093/ehjci/jeac217
M3 - Journal article
C2 - 36394344
AN - SCOPUS:85147045349
VL - 24
SP - 212
EP - 222
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 2
ER -
ID: 366824692