Relationship of non-invasive quantification of myocardial blood flow to arrhythmic events in patients with implantable cardiac defibrillators

Autor: Ravi V. Shah, Matthew C. Konerman, Venkatesh L. Murthy, Ryan Cunnane, Michael Ghannam, Edward P. Ficaro, James R. Corbett, Richard L. Weinberg, John J. Lazarus, Keri M. Hiller, Ashraf Saleh, Krasimira Mikhova, Hong Jun Yun
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Heart Ventricles
Population
Myocardial Ischemia
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
03 medical and health sciences
Myocardial perfusion imaging
0302 clinical medicine
Coronary Circulation
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
education
Aged
Proportional Hazards Models
education.field_of_study
Ejection fraction
medicine.diagnostic_test
Proportional hazards model
business.industry
Myocardial Perfusion Imaging
Arrhythmias
Cardiac
Heart
Middle Aged
medicine.disease
Defibrillators
Implantable
Perfusion
Rubidium-82
Treatment Outcome
Cardiac PET
Positron-Emission Tomography
Heart failure
Tachycardia
Ventricular
Cardiology
Female
Cardiomyopathies
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Journal of Nuclear Cardiology. 26:417-427
ISSN: 1532-6551
1071-3581
DOI: 10.1007/s12350-017-0975-z
Popis: Ischemia contributes to arrhythmogenesis though its role is incompletely understood. Abnormal myocardial perfusion measured by PET imaging may predict ventricular arrhythmias (VAs) in a high-risk population. Patients with implantable cardiac defibrillators who had undergone rubidium-82 cardiac PET imaging were identified. Patients were stratified by median MBF and MFR values for analysis. The Cox proportional hazards model was used to assess the impact of myocardial perfusion on survival free of VT independent of critical covariates. A total of 159 patients (124 (78%) males, median age 65.9 years, IQR [56.76-72.63]) were followed for 1.43 years IQR [0.83-2.21]. VA occurred in 29 patients (23.7%). After adjustment for ejection fraction, age, and sex, impaired stress MBF was associated with an increased risk of VA (adjusted HR per ml/min/g 1.52, 95% CI (1.01-2.31), P = 0.04). Summed rest and stress scores were not predictive of VA. Among patients with severe LV dysfunction, stress MBF remained an independent predictor of VA (adjusted HR per 1 ml/min/g HR 1.69, 95% CI (1.03-11.36), P = 0.03), while residual EF, summed rest, and summed stress scores were not (P > 0.05). Impaired stress myocardial blood flow was associated with less survival free of ventricular arrhythmias.
Databáze: OpenAIRE
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