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von Felten E, Benz DC, Benetos G, et al. Prognostic value of regional myocardial flow reserve derived from . Eur J Nucl Med Mol Imaging. 2021;49(1):311-320doi: 10.1007/s00259-021-05459-0.
von Felten, E., Benz, D. C., Benetos, G., Baehler, J., Patriki, D., Rampidis, G. P., Giannopoulos, A. A., Bakula, A., Gräni, C., Pazhenkottil, A. P., Gebhard, C., Fuchs, T. A., Kaufmann, P. A., & Buechel, R. R. (2021). Prognostic value of regional myocardial flow reserve derived from . European journal of nuclear medicine and molecular imaging, 49(1), 311-320. https://doi.org/10.1007/s00259-021-05459-0
von Felten, Elia, et al. "Prognostic value of regional myocardial flow reserve derived from ." European journal of nuclear medicine and molecular imaging vol. 49,1 (2021): 311-320. doi: https://doi.org/10.1007/s00259-021-05459-0
von Felten E, Benz DC, Benetos G, Baehler J, Patriki D, Rampidis GP, Giannopoulos AA, Bakula A, Gräni C, Pazhenkottil AP, Gebhard C, Fuchs TA, Kaufmann PA, Buechel RR. Prognostic value of regional myocardial flow reserve derived from . Eur J Nucl Med Mol Imaging. 2021 Dec;49(1):311-320. doi: 10.1007/s00259-021-05459-0. Epub 2021 Jun 30. PMID: 34191100; PMCID: PMC8712296.
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Eur J Nucl Med Mol Imaging. 2021 Dec;49(1):311-320. doi: 10.1007/s00259-021-05459-0. Epub 2021 Jun 30.

Prognostic value of regional myocardial flow reserve derived from .

European journal of nuclear medicine and molecular imaging

Elia von Felten, Dominik C Benz, Georgios Benetos, Jessica Baehler, Dimitri Patriki, Georgios P Rampidis, Andreas A Giannopoulos, Adam Bakula, Christoph Gräni, Aju P Pazhenkottil, Catherine Gebhard, Tobias A Fuchs, Philipp A Kaufmann, Ronny R Buechel

Affiliations

  1. Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistr. 100, CH-8091, Zurich, Switzerland.
  2. Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistr. 100, CH-8091, Zurich, Switzerland. [email protected].

PMID: 34191100 PMCID: PMC8712296 DOI: 10.1007/s00259-021-05459-0

Abstract

PURPOSE: To assess the prognostic value of regional quantitative myocardial flow measures as assessed by

METHODS: We retrospectively included 150 consecutive patients with suspected CAD who underwent clinically indicated 13 N-ammonia PET-MPI and who did not undergo revascularization within 90 days of PET-MPI. The presence or absence of a decreased global myocardial flow reserve (i.e., MFR < 2) as well as decreased regional MFR (i.e., ≥ 2 adjacent segments with MFR < 2) was recorded, and patients were classified as having preserved global and regional MFR (MFR group 1), preserved global but decreased regional MFR (MFR group 2), or decreased global and regional MFR (MFR group 3). We obtained follow-up regarding major adverse cardiac events (MACE, i.e., a combined endpoint including all-cause death, non-fatal myocardial infarction, and late revascularization) and all-cause death.

RESULTS: Over a median follow-up of 50 months (IQR 38-103), 30 events occurred in 29 patients. Kaplan-Meier analysis showed significantly reduced event-free and overall survival in MFR groups 2 and 3 compared to MFR group 1 (log-rank: p = 0.015 and p = 0.013). In a multivariable Cox regression analysis, decreased regional MFR was an independent predictor for MACE (adjusted HR 3.44, 95% CI 1.17-10.11, p = 0.024) and all-cause death (adjusted HR 4.72, 95% CI 1.07-20.7, p = 0.04).

CONCLUSIONS: A decreased regional MFR as assessed by 13 N-ammonia PET-MPI confers prognostic value by identifying patients at increased risk for future adverse cardiac outcomes and all-cause death.

© 2021. The Author(s).

Keywords: Coronary artery disease; Myocardial blood flow; Myocardial flow reserve; Positron emission tomography

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