Abstract 12519: Age Impacts the Interpretation of Myocardial Blood Flow Values in Cardiac PET/CT

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Hannah E Raasch ◽  
Raymond O McCubrey ◽  
Jon-David Ethington ◽  
Steve Mason ◽  
Viet T Le ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Cardiac Pet ◽  
Flow Reserve ◽  
Age Related ◽  
Pet Ct ◽  
History Of ◽  
Global Estimates ◽  
Traditional Risk Factors

Introduction: Quantitative myocardial blood flow (MBF) obtained via Rb82 PET/CT using regadenoson provides the ability to assess ischemia through analysis of stress MBF and coronary flow reserve (CFR), the augmentation of flow expressed as a stress/rest ratio. It is unknown to what extent, if any, age-related changes in arteries (i.e. arterial stiffening, atherosclerosis) impact MBF and, thus, the interpretation of ischemia. Hypothesis: MBF values change as a function of age and impact PET interpretation. Methods: Patients who underwent PET/CT from May 2013 to April 2015 with normal perfusion images and no history of PCI or CABG were included (n=3329, 1720 women, 1498 men). Rest MBF, stress MBF, and CFR) (mL/min/g) were recorded in all vessels separated by gender and by age <60 or ≥60. Analysis was conducted on individual vessels and global estimates were calculated averaging all vessels. Estimated average median differences between age <60 and ≥60 were adjusted for traditional cardiovascular risk factors (BMI, smoking, diabetes, hypertension, hyperlipidemia, family history). Results: Effects of Age on Global MBF Adjusted for Traditional Risk Factors Conclusions: In patients ≥60 years of age with normal perfusion imaging, rest MBF increases, stress MBF decreases, and the resultant CFR is decreased, all statistically significant. This may reflect a higher fixed level of vasodilation in older vessels at rest and a more limited ability to vasodilate with stress independent of other CV risk factors. Given the increasing use of PET/CT for ischemia assessment, it is important to recognize expected MBF changes with age to decrease false positive studies and unwarranted invasive testing.

scholarly journals Survival Outcome with Routine Clinical Use of 82Rb PET/CT Myocardial Blood Flow (MBF) Quantification

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
S Wan ◽  
ME Speechly-Dick ◽  
LJ Menezes ◽  
R Endozo ◽  
R Bell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Blood Flow ◽  
Ejection Fraction ◽  
Myocardial Blood Flow ◽  
Univariate Analysis ◽  
Myocardial Flow Reserve ◽  
Flow Reserve ◽  
Pet Ct ◽  
Myocardial Flow

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): NIHR Biomedical Research Centre, University College London Hospitals Background The prognostic value of 82Rb PET/CT derived myocardial blood flow (MBF) is increasingly recognised in both general and specific cardiovascular populations. Purpose This study investigates the prognostic potential of MBF in a large cohort of patients undergoing routine 82Rb PET/CT examination. Methods 1148 consecutive patients (687 males, mean age 64 +/- 12 years) whom had been referred for 82Rb PET/CT examination in a single centre were included in this study.  All patients completed a stress 82Rb PET/CT with adenosine infusion, paired with a rest study.  Dynamic PET acquisitions were performed in both. Cardiovascular risk factors were documented as per clinical routine. Images were checked for quality and analysed using a proprietary software by an experienced operator to derive MBF parameters.  Overall survival was recorded following the study. Results Median follow-up period was 71 +/- 28 months.  Mean survival was 121 (95% CI: 118-124) months. On univariate analysis, global myocardial flow reserve &lt;1.77 was associated with a higher all-cause mortality (p &lt; 0.001). Other parameters including higher age (&gt; =76 years), lower BMI (&lt;21), qualitative abnormality on the myocardial perfusion scan (MPS), low hyperaemic ejection fraction on the gated studies (stress &lt; 37 and rest &lt; 34). Patients being on cardiac glycosides and diuretics were also significant predictor of poor prognosis (p &lt; 0.001) on univariate analysis, presumably reflecting underlying arrhythmia and heart failure. A multivariate Cox regression analysis (step-wise Forward Wald), comprising of the above significant univariate markers, highlighted global myocardial flow reserve (HR: 2.6, 95%CI: 1.8-3.6, p &lt; 0.001), age (HR: 2.8, 95%CI: 2.0-3.9, p &lt; 0.001),, BMI (HR: 2.7, 95%CI: 1.7-4.1, p &lt; 0.001),, ejection fraction (stress - HR: 3.3, 95%CI: 2.3-4.8, p &lt; 0.001), MPS (HR: 1.5, 95%CI: 1.1-2.1, p = 0.024), and patients on diuretics (HR: 1.8, 95%CI: 1.2-2.5, p = 0.003) were independent predictors of overall survival (overall model: p &lt; 0.001) Discussion We show that high volume routinely derived MBF in patients undergoing 82Rb PET/CT is a strong predictor of mortality and independent of other risk factors. This has important clinical implication for measuring not only interventional treatment but also measuring the effect of lifestyle and medical strategies.

P6240The impact of stress myocardial blood flow as a very strong predictor for all-cause mortality, cardiovascular mortality and adverse cardiac and cerebrovascular event in hemodialysis population

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Umemoto ◽  
S Ooshima ◽  
M Katou ◽  
H Kajiura ◽  
S Inoue ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Strong Predictor ◽  
High Stress ◽  
Cerebrovascular Event ◽  
Net Reclassification Improvement ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
All Cause Mortality

Abstract Background In the clinical setting, ischemic heart disease (IHD) is a major problem not only in general patients but also in regular hemodialysis (HD) patients. 13ammonia positron emission tomography (13NH3PET) is an established and excellent diagnostic device for IHD. Although coronary flow reserve is the most important index in IHD diagnosis, there are limited data about stress myocardial blood flow (MBF). We investigated the prognosis predictability of stress MBF in all-cause mortality, cardiovascular (CV) mortality and adverse cardiac and cerebrovascular event (MACCE). Methods and results A total 438 of HD patients who undergone 13NH3PET for suspected IHD were enrolled. 29 cases were excluded due to revascularization therapy in 60 days. In total we collected 409 eligible cases. All patients were undergone13NH3PET at Nagoya Radiological Diagnosis Foundation. Patients were divided into two group according to the median value of stress MBF levels; low stress MBF group (<2.12) and high stress MBF group (≥2.12). We followed up them up to 4.2 years (median 2.4 years) and collected their data. We evaluated their all-cause mortality, CV mortality and MACCE. Kaplan-Meyer analysis shows that intergroup difference in all-cause mortality (log rank p=0.001, hazard ratio [HR] 0.411, 95% confident interval [CI] 0.261–0.632), CV mortality (log rank p=0.002, HR 0.324, 95% CI 0.157–0.625) and MACCE (log rank p<0.001, HR 0.465, 95% CI 0.324–0.657). Multiple cox analysis that include established risk factors shows CFR is an independent risk factor for all-cause mortality (HR 0.261, 95% CI 0.154–0.442), CV mortality (HR 0.172, 95% CI 0.079–0.374) and MACCE (HR 0.329, 95% CI 0.213–0.503). As a result of the incremental value with C-index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) when CFR added into a model with established risk factors, each indicator shows adding stress MBF on established risk factors improve the predictability in all-cause mortality, CV mortality and MACCE (all-cause mortality; NRI 0.642, p<0.001, IDI 0.091, p<0.001, CV mortality NRI 0.809, p<0.001, IDI 0.116, p<0.001, MACCE; NRI 0.646, p<0.001, IDI 0.072, p<0.001). Conclusion Considering prognosis of HD population, stress MBF is an important and independent predictor for all-cause mortality, CV mortality and MACCE. As a result of our investigation, stress MBF is one of most strong predictors in HD population.

13N-ammonia PET/CT stress myocardial blood flow compared to fractional flow reserve in coronary artery disease

2020 ◽  
Vol 41 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Jouke J. Boer ◽  
Johan J.J.S. Kappelhof ◽  
Friso M. van der Zant ◽  
Maurits Wondergem ◽  
Hans(J) B.R.M. de Swart ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
Pet Ct ◽  
Artery Disease

scholarly journals GENDER DIFFERENCES IN MYOCARDIAL BLOOD FLOW IN CARDIAC PET/CT WITH REGADENOSON

2015 ◽  
Vol 65 (10) ◽  
pp. A1270
Author(s):  
Jason Allen ◽  
Steve Mason ◽  
Jon-David Ethington ◽  
Jeffrey Anderson ◽  
Raymond McCubrey ◽  
...  
Keyword(s):  
Gender Differences ◽  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Cardiac Pet ◽  
Pet Ct

scholarly journals Comparison of the Prognostic Value of Global and Regional Myocardial Flow Capacity Radius, Myocardial Flow Reserve, and Stress Myocardial Blood Flow Using Rubidium-82 with SiPM PET/CT

2021 ◽  
Author(s):  
Matthieu DIETZ ◽  
Christel H Kamani ◽  
Gilles Allenbach ◽  
Vladimir Rubimbura ◽  
Stephane Fournier ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Myocardial Flow Reserve ◽  
Flow Capacity ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
Pet Ct ◽  
Myocardial Flow ◽  
Rubidium 82 ◽  
Regional Myocardial Flow

Abstract Purpose The aim of this study was to assess the most reliable quantitative variable on Rubidium-82 (82Rb) cardiac PET/CT for predicting major adverse cardiovascular events (MACE), on the latest PET camera using silicon photomultipliers digital readout (SiPM) technology. Methods We prospectively enrolled 274 consecutive participants with suspected myocardial ischemia. Participants underwent 82Rb cardiac SiPM PET/CT and were followed-up for MACE over 652 days (interquartile range: 559 to 751 days). For each participant, global and regional myocardial flow reserve (MFR), stress myocardial blood flow (stress MBF) and their combination as myocardial flow capacity radius (MFC radius) were measured. Results On receiver operator curve analysis, MACE prediction was similar for global and regional MFR, stress MBF, and MFC radius (area under the curve; (i) Global: 0.70 vs. 0.71 and 0.73, and (ii) Regional: 0.71 vs. 0.71 and 0.73, respectively, p > 0.1 for all pairwise comparisons). On multivariable analysis, (i) Global: MFR < 1.98, stress MBF < 1.94 mL/g/min, and MFC radius < 3.12, as well as (ii) Regional: MFR < 1.75, stress MBF < 1.75 mL/g/min, and MFC radius < 2.7, emerged all as similar independent predictors of MACE (p < 0.001 for all). Conclusions Using the latest SiPM PET technology with 82Rb, global and regional MFR, stress MBF, and MFC radius are similar powerful predictors of cardiovascular event.

PW315 Myocardial blood flow reserve correlates with semiquantitative degree of ischemia in PET/CT 13N-Ammonia scans: a strong correlation?

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e321
Author(s):  
Erick Alexanderson-Rosas ◽  
Luis E. Juarez Orozco ◽  
Riemer Slart ◽  
Myriam M. Martínez Aguilar ◽  
Antonio Jordán Ríos ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Strong Correlation ◽  
Flow Reserve ◽  
Pet Ct ◽  
Myocardial Blood Flow Reserve
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