Mortality Prediction by Quantitative PET Perfusion Expressed as Coronary Flow Capacity With and Without Revascularization.

JACC. Cardiovascular Imaging
K Lance GouldDejian Lai

Abstract

This study sought to determine the relationship between the severity of reduced quantitative perfusion parameters and mortality with and without revascularization. The physiological mechanisms for differential mortality risk of coronary flow reserve (CFR) and coronary flow capacity (CFC) before and after revascularization are unknown. Global and regional rest-stress (ml/min/g), CFR, their regional per-pixel combination as CFC, and relative stress in ml/min/g were measured as percent of LV in all serial routine 5,274 diagnostic PET scans with systematic follow-up over 10 years (mean 4.2 ± 2.5 years) for all-cause mortality with and without revascularization. Severely reduced CFR of 1.0 to 1.5 and stress perfusion ≤1.0 cc/min/g incurred increasing size-dependent risks that were additive because regional severely reduced CFC (CFCsevere) was associated with the highest major adverse cardiac event rate of 80% (p < 0.0001 vs. either alone) and a mortality risk of 14% (vs. 2.3% for no CFCsevere; p = 0.001). Small regions of CFCsevere ≤0.5% predicted high risk (p < 0.0001 vs. no CFCsevere) related to a wave front of border zones at risk around the small most severe center. By receiver-operating characteristic analysis, relative stress ...Continue Reading

References

Apr 16, 2013·JACC. Cardiovascular Imaging·Andres F VasquezK Lance Gould
Nov 24, 2018·Journal of the American College of Cardiology·K Lance Gould, Nils P Johnson
Feb 27, 2019·European Journal of Nuclear Medicine and Molecular Imaging·Robert M BoberDaniel P Morin
Sep 29, 2019·Journal of the American College of Cardiology·Krishna K PatelTimothy M Bateman

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Citations

Nov 30, 2020·JACC. Cardiovascular Imaging·Juhani Knuuti, Antti Saraste
Jul 20, 2021·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Nils P Johnson, K Lance Gould
Sep 26, 2021·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Nils P Johnson, K Lance Gould
Nov 16, 2021·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Alexis Poitrasson-RivièreVenkatesh L Murthy

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