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Cardiopulmonary transit time : A novel PET imaging biomarker of in vivo physiology for risk stratification of heart transplant recipients
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- Harms, H. J. (författare)
- Brigham & Womens Hosp, Cardiovasc Imaging Program, Dept Radiol, 75 Francis St, Boston, MA 02115 USA.;Brigham & Womens Hosp, Cardiovasc Imaging Program, Dept Med, 75 Francis St, Boston, MA 02115 USA.;Brigham & Womens Hosp, Div Nucl Med & Mol Imaging, 75 Francis St, Boston, MA 02115 USA.;Aarhus Univ Hosp, Inst Clin Med, Aarhus, Denmark.
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- Bravo, P. E. (författare)
- Hosp Univ Penn, Div Cardiovasc Med, Dept Med, 3400 Spruce St, Philadelphia, PA 19104 USA.;Hosp Univ Penn, Div Nucl Med, Dept Radiol, 3400 Spruce St, Philadelphia, PA 19104 USA.
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- Bajaj, N. S. (författare)
- Brigham & Womens Hosp, Cardiovasc Imaging Program, Dept Radiol, 75 Francis St, Boston, MA 02115 USA.;Brigham & Womens Hosp, Cardiovasc Imaging Program, Dept Med, 75 Francis St, Boston, MA 02115 USA.;Brigham & Womens Hosp, Div Nucl Med & Mol Imaging, 75 Francis St, Boston, MA 02115 USA.
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- Brigham & Womens Hosp, Cardiovasc Imaging Program, Dept Radiol, 75 Francis St, Boston, MA 02115 USA;Brigham & Womens Hosp, Cardiovasc Imaging Program, Dept Med, 75 Francis St, Boston, MA 02115 USA.;Brigham & Womens Hosp, Div Nucl Med & Mol Imaging, 75 Francis St, Boston, MA 02115 USA.;Aarhus Univ Hosp, Inst Clin Med, Aarhus, Denmark. Hosp Univ Penn, Div Cardiovasc Med, Dept Med, 3400 Spruce St, Philadelphia, PA 19104 USA.;Hosp Univ Penn, Div Nucl Med, Dept Radiol, 3400 Spruce St, Philadelphia, PA 19104 USA. (creator_code:org_t)
- 2021-01-04
- 2022
- Engelska.
- Ingår i: Journal of Nuclear Cardiology. - : Springer Nature. - 1071-3581 .- 1532-6551. ; 29, s. 1234-1244
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
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- Background: Myocardial blood flow (MBF) can be quantified using dynamic PET studies. These studies also inherently contain tomographic images of early bolus displacement, which can provide cardiopulmonary transit times (CPTT) as measure of cardiopulmonary physiology. The aim of this study was to assess the incremental prognostic value of CPTT in heart transplant (OHT) recipients.Methods: 94 patients (age 56 +/- 16 years, 78% male) undergoing dynamic N-13-ammonia stress/rest studies were included, of which 68 underwent right-heart catherization. A recently validated cardiac allograft vasculopathy (CAV) score based on PET measures of regional perfusion, peak MBF and left-ventricular (LV) ejection fraction (LVEF) was used to identify patients with no, mild or moderate-severe CAV. Time-activity curves of the LV and right ventricular (RV) cavities were obtained and used to calculate the difference between the LV and RV bolus midpoint times, which represents the CPTT and is expressed in heartbeats. Patients were followed for a median of 2.5 years for the occurrence of major adverse cardiac events (MACE), including cardiovascular death, hospitalization for heart failure or acute coronary syndrome, or re-transplantation.Results: CPTT was significantly correlated with cardiac filling pressures (r = .434, P = .0002 and r = .439, P = .0002 for right atrial and pulmonary wedge pressure), cardiac output (r = - .315, P = .01) and LVEF (r = - .513, P < .0001). CPTT was prolonged in patients with MACE (19.4 +/- 6.0 vs 14.5 +/- 3.0 heartbeats, P < .001, N = 15) with CPTT >= 17.75 beats showing optimal discriminatory value in ROC analysis. CPTT >= 17.75 heartbeats was associated with a 10.1-fold increased risk (P < .001) of MACE and a 7.3-fold increased risk (P < .001) after adjusting for PET-CAV, age, sex and time since transplant.Conclusion: Measurements of cardiopulmonary transit time provide incremental risk stratification in OHT recipients and enhance the value of multiparametric dynamic PET imaging, particularly in identifying high-risk patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
Nyckelord
- Transplant rejection
- PET
- blood flow
- RV function
- image analysis
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- art (ämneskategori)
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- Harms, H. J.
- Bravo, P. E.
- Bajaj, N. S.
- Zhou, W.
- Gupta, A.
- Tran, T.
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- Taqueti, V. R.
- Hainer, J.
- Bibbo, C.
- Dorbala, S.
- Blankstein, R.
- Mehra, M.
- Sörensen, Jens
- Givertz, M. M.
- Di Carli, M. F.
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