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Prognostic value of vasodilator response using rubidium-82 positron emission tomography myocardial perfusion imaging in patients with coronary artery disease
- Source :
- European journal of nuclear medicine and molecular imaging. 45(4)
- Publication Year :
- 2017
-
Abstract
- Prognostic value of positron emission tomography (PET) myocardial perfusion imaging (MPI) is well established. There is paucity of data on how the prognostic value of PET relates to the hemodynamic response to vasodilator stress. We hypothesize that inadequate hemodynamic response will affect the prognostic value of PET MPI. Using a multicenter rubidium (Rb)-82 PET registry, 3406 patients who underwent a clinically indicated rest/stress PET MPI with a vasodilator agent were analyzed. Patients were categorized as, “responders” [increase in heart rate ≥ 10 beats per minute (bpm) and decrease in systolic blood pressure (SBP) ≥10 mmHg], “partial responders” (either a change in HR or SBP), and “non-responders” (no change in HR or SBP). Primary outcome was all-cause death (ACD), and secondary outcome was cardiac death (CD). Ischemic burden was measured using summed stress score (SSS) and % left ventricular (LV) ischemia. After a median follow-up of 1.68 years (interquartile range = 1.17- 2.55), there were 7.9% (n = 270) ACD and 2.6% (n = 54) CD. Responders with a normal PET MPI had an annualized event rate (AER) of 1.22% (SSS of 0–3) and 1.58% (% LV ischemia = 0). Partial and non-responders had higher AER with worsening levels of ischemic burden. In the presence of severe SSS ≥12 and LV ischemia of ≥10%, partial responders had an AER of 10.79% and 10.36%, compared to non-responders with an AER of 19.4% and 12.43%, respectively. Patient classification was improved when SSS was added to a model containing clinical variables (NRI: 42%, p
- Subjects :
- Male
medicine.medical_specialty
Haemodynamic response
Vasodilator Agents
Coronary Artery Disease
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
Coronary artery disease
03 medical and health sciences
Myocardial perfusion imaging
0302 clinical medicine
Percutaneous Coronary Intervention
Interquartile range
Internal medicine
Heart rate
Medicine
Humans
Radiology, Nuclear Medicine and imaging
Aged
medicine.diagnostic_test
business.industry
Myocardial Perfusion Imaging
General Medicine
Middle Aged
medicine.disease
Prognosis
SSS
Rubidium-82
Blood pressure
Positron-Emission Tomography
Cardiology
Exercise Test
Female
business
Rubidium Radioisotopes
Subjects
Details
- ISSN :
- 16197089
- Volume :
- 45
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- European journal of nuclear medicine and molecular imaging
- Accession number :
- edsair.doi.dedup.....75fd020b8777ab2768966fe3b94c8407