1. Prognostic value of regional myocardial flow reserve derived from 13N-ammonia positron emission tomography in patients with suspected coronary artery disease
- Author
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Jessica Baehler, Ronny R. Buechel, Elia von Felten, Christoph Gräni, Andreas A. Giannopoulos, Georgios Benetos, Dimitri Patriki, Aju P. Pazhenkottil, Georgios Rampidis, Catherine Gebhard, Dominik C. Benz, Adam Bakula, Tobias A. Fuchs, and Philipp A. Kaufmann
- Subjects
medicine.medical_specialty ,Positron emission tomography ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Revascularization ,Myocardial flow reserve ,Myocardial blood flow ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,Myocardial perfusion imaging ,0302 clinical medicine ,Ammonia ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Myocardial infarction ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Proportional hazards model ,Myocardial Perfusion Imaging ,General Medicine ,medicine.disease ,Prognosis ,Positron-Emission Tomography ,Cardiology ,Original Article ,business ,Mace - Abstract
Purpose To assess the prognostic value of regional quantitative myocardial flow measures as assessed by 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI) in patients with suspected coronary artery disease (CAD). Methods We retrospectively included 150 consecutive patients with suspected CAD who underwent clinically indicated 13 N-ammonia PET-MPI and who did not undergo revascularization within 90 days of PET-MPI. The presence or absence of a decreased global myocardial flow reserve (i.e., MFR Results Over a median follow-up of 50 months (IQR 38–103), 30 events occurred in 29 patients. Kaplan–Meier analysis showed significantly reduced event-free and overall survival in MFR groups 2 and 3 compared to MFR group 1 (log-rank: p = 0.015 and p = 0.013). In a multivariable Cox regression analysis, decreased regional MFR was an independent predictor for MACE (adjusted HR 3.44, 95% CI 1.17–10.11, p = 0.024) and all-cause death (adjusted HR 4.72, 95% CI 1.07–20.7, p = 0.04). Conclusions A decreased regional MFR as assessed by 13 N-ammonia PET-MPI confers prognostic value by identifying patients at increased risk for future adverse cardiac outcomes and all-cause death.
- Published
- 2021