Defining the prognostic value of [15O]H2O positron emission tomography-derived myocardial ischaemic burden.

European Heart Journal Cardiovascular Imaging
Pepijn A van DiemenPaul Knaapen

Abstract

Myocardial ischaemic burden (IB) is used for the risk stratification of patients with coronary artery disease (CAD). This study sought to define a prognostic threshold for quantitative [15O]H2O positron emission tomography (PET)-derived IB. A total of 623 patients with suspected or known CAD who underwent [15O]H2O PET perfusion imaging were included. The endpoint was a composite of death and non-fatal myocardial infarction (MI). A hyperaemic myocardial blood flow (hMBF) and myocardial flow reserve (MFR)-derived IB were determined. During a median follow-up time of 6.7 years, 62 patients experienced an endpoint. A hMBF IB of 24% and MFR IB of 28% were identified as prognostic thresholds. Patients with a high hMBF or MFR IB (above threshold) had worse outcome compared to patients with a low hMBF IB [annualized event rates (AER): 2.8% vs. 0.6%, P < 0.001] or low MFR IB [AER: 2.4% vs. 0.6%, P < 0.001]. Patients with a concordant high IB had the worst outcome (AER: 3.1%), whereas patients with a concordant low or discordant IB result had similar and low AERs of 0.5% and 0.9% (P = 0.953), respectively. Both thresholds were of prognostic value beyond clinical characteristics, however, only the hMBF IB threshold remained predictive whe...Continue Reading

References

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Jan 29, 2011·European Journal of Nuclear Medicine and Molecular Imaging·Hendrik J HarmsMark Lubberink
Jun 14, 2014·JACC. Cardiovascular Imaging·Leslee J ShawUNKNOWN National Institutes of Health/National Heart, Lung, and Blood Institute-Sponsored ISCHEMIA Trial Investigators
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Sep 29, 2019·Journal of the American College of Cardiology·Krishna K PatelTimothy M Bateman
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Oct 18, 2019·European Heart Journal Cardiovascular Imaging·Michiel J BomPaul Knaapen
Apr 1, 2020·The New England Journal of Medicine·David J MaronUNKNOWN ISCHEMIA Research Group

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