Sharon Chih1, Aun Yeong Chong2, Jordan Bernick3, George A Wells3, Robert A deKemp3, Ross A Davies4, Ellamae Stadnick4, Derek Y So2, Christopher Overgaard5, Lisa M Mielniczuk4, Rob S B Beanlands6. 1. Division of Cardiology, Heart Failure and Transplantation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada. schih@ottawaheart.ca. 2. Division of Cardiology, Interventional Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada. 3. Division of Cardiology, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON, Canada. 4. Division of Cardiology, Heart Failure and Transplantation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada. 5. Division of Cardiology, Toronto General Hospital-University Health Network, Toronto, Canada. 6. Cardiac Imaging, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Abstract
BACKGROUND: We previously demonstrated high diagnostic accuracy of Rubidium-82 positron emission tomography (PET) myocardial blood flow (MBF) quantification for CAV. The purpose of this study was to validate multiparametric PET detection of CAV by combined rate-pressure-product-corrected myocardial flow reserve (cMFR), stress MBF, and coronary vascular resistance (CVR) assessment. METHODS AND RESULTS: Diagnostic CAV cut-offs of cMFR < 2.9, stress MBF < 2.3, CVR > 55 determined in a previous study (derivation) were assessed in heart transplant recipients referred for coronary angiography and intravascular ultrasound (IVUS) (validation). CAV was defined as International Society of Heart and Lung Transplantation CAV1-3 on angiography; and maximal intimal thickness ≥ 0.5 mm on IVUS. Eighty patients (derivation n = 40, validation n = 40) were included: 80% male, mean age 54±14 years, 4.5±5.6 years post transplant. The prevalence of CAV was 44% on angiography and 78% on IVUS. Combined PET cMFR < 2.9, stress MBF < 2.3, CVR > 55 CAV assessment yielded high 88% (specificity 75%) and 83% (specificity 40%) sensitivity for ≥ 1 abnormal parameter and high 88% (sensitivity 59%) and 90% (sensitivity 43%) specificity for 3 abnormal parameters, in the derivation and validation cohorts, respectively. CONCLUSION: We validate the diagnostic accuracy of multiparametric PET flow quantification by cMFR, stress MBF, and CVR for CAV.
BACKGROUND: We previously demonstrated high diagnostic accuracy of Rubidium-82 positron emission tomography (PET) myocardial blood flow (MBF) quantification for CAV. The purpose of this study was to validate multiparametric PET detection of CAV by combined rate-pressure-product-corrected myocardial flow reserve (cMFR), stress MBF, and coronary vascular resistance (CVR) assessment. METHODS AND RESULTS: Diagnostic CAV cut-offs of cMFR < 2.9, stress MBF < 2.3, CVR > 55 determined in a previous study (derivation) were assessed in heart transplant recipients referred for coronary angiography and intravascular ultrasound (IVUS) (validation). CAV was defined as International Society of Heart and Lung Transplantation CAV1-3 on angiography; and maximal intimal thickness ≥ 0.5 mm on IVUS. Eighty patients (derivation n = 40, validation n = 40) were included: 80% male, mean age 54±14 years, 4.5±5.6 years post transplant. The prevalence of CAV was 44% on angiography and 78% on IVUS. Combined PET cMFR < 2.9, stress MBF < 2.3, CVR > 55 CAV assessment yielded high 88% (specificity 75%) and 83% (specificity 40%) sensitivity for ≥ 1 abnormal parameter and high 88% (sensitivity 59%) and 90% (sensitivity 43%) specificity for 3 abnormal parameters, in the derivation and validation cohorts, respectively. CONCLUSION: We validate the diagnostic accuracy of multiparametric PET flow quantification by cMFR, stress MBF, and CVR for CAV.
Authors: M R Costanzo; D C Naftel; M R Pritzker; J K Heilman; J P Boehmer; S C Brozena; G W Dec; H O Ventura; J K Kirklin; R C Bourge; L W Miller Journal: J Heart Lung Transplant Date: 1998-08 Impact factor: 10.247
Authors: M R Mehra; H O Ventura; D D Stapleton; F W Smart; T C Collins; S R Ramee Journal: J Heart Lung Transplant Date: 1995 Jul-Aug Impact factor: 10.247
Authors: Matthew C Konerman; John J Lazarus; Richard L Weinberg; Ravi V Shah; Michael Ghannam; Scott L Hummel; James R Corbett; Edward P Ficaro; Keith D Aaronson; Monica M Colvin; Todd M Koelling; Venkatesh L Murthy Journal: Circ Heart Fail Date: 2018-06 Impact factor: 8.790
Authors: Uttam M Shrestha; Maria Sciammarella; Miguel Hernandez Pampaloni; Elias H Botvinick; Grant T Gullberg; Teresa DeMarco; Youngho Seo Journal: Int J Cardiovasc Imaging Date: 2020-10-29 Impact factor: 2.357