Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
Relationship of non-invasive quantification of myocardial blood flow to arrhythmic events in patients with implantable cardiac defibrillators.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Ghannam Michael, Mikhova Krasimira, Yun Hong Jun, Lazarus John J, Konerman Matthew, Saleh Ashraf, Weinberg Richard L, Cunnane Ryan, Shah Ravi V, Hiller Keri M, Ficaro Edward P, Corbett James R, Murthy Venkatesh L
Аннотация
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: Impaired stress myocardial blood flow was associated with less survival free of ventricular arrhythmias.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: Impaired stress myocardial blood flow was associated with less survival free of ventricular arrhythmias.
Предметные рубрики MeSH
AgedArrhythmias, CardiacCardiomyopathiesCoronary CirculationDefibrillators, ImplantableFemaleFollow-Up StudiesHeartHeart VentriclesHumansMaleMiddle AgedMyocardial IschemiaMyocardial Perfusion ImagingPerfusionPositron-Emission TomographyProportional Hazards ModelsProspective StudiesTachycardia, VentricularTreatment Outcome