Serial Assessment of Coronary Flow Reserve by Rubidium-82 Positron Emission Tomography Predicts Mortality in Heart Transplant Recipients.
Serial Assessment of Coronary Flow Reserve by Rubidium-82 Positron Emission Tomography Predicts Mortality in Heart Transplant Recipients.
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DOI：
10.1016/j.jcmg.2018.08.025
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Sinusas AJ
中科院分区：
文献类型：
--
作者：
Feher A;Srivastava A;Quail MA;Boutagy NE;Khanna P;Wilson L;Miller EJ;Liu YH;Lee F;Sinusas AJ
本研究旨在评价Rb-82(82Rb)正电子发射断层扫描(PET)对心脏移植(HT)患者冠状动脉血流储备(CFR)动态变化的长期预测价值。同种异体心脏移植物血管病变是移植受者晚期死亡率的主要决定因素。在HT患者中，通过PET成像进行连续CFR定量的长期预后价值尚不清楚。有高血压病史的89例患者(男性占71%，术后7.0±5.7年，年龄57±11岁)在2008年3月1日至2009年7月31日期间接受动态静息和应激(潘生丁)82Rb正电子发射计算机断层扫描(PET-1)。使用美国食品和药物管理局批准的软件(Corridor 4 DM，2017版)重新处理PET心肌灌注研究，以计算CFR。对69例患者进行PET(PET-2)显像，随访时间为(1.9±0.3)年。根据CFR值对患者进行分类，认为CFR1.5为低CFR值，≤；1.5为高CFR值。在中位数为8.6年的随访时间中发生了40例死亡。PET-1的低CFR值与全因死亡率增加2.77倍相关(95%可信区间[CI]：1.3-5.74；p=0.004)。在接受随访的患者中，CFR值随着时间的推移而降低(PET-1：2.11±0.74vs.PET-2：1.81±0.61；p=0.003)。25例患者根据PET-1和PET-2进行重新分类(高CFR：18例，低CFR：7例)。在从高到低重新分类的患者中，总体生存率与低CFR到低CFR的患者相似，而从低到高重新分类的患者与高CFR到高CFR的患者的生存率相似。在PET-2患者的多变量COX回归分析中，基线CFR较高(危险比增加0.73个单位(一个标准差)：0.36，95%CI：0.16至0.82)和CFR从PET-1减少到PET-2(HR减少0.79个单位(一个标准差)：1.50至7.84)是全因死亡率的独立预测因素。82Rb PET对CFR的连续评估可独立预测高血压患者的长期死亡率。
This study aimed to evaluate the long-term prognostic value of serial assessment of coronary flow reserve (CFR) by rubidium Rb 82 (82Rb) positron emission tomography (PET) in heart transplantation (HT) patients. Cardiac allograft vasculopathy is a major determinant of late mortality in HT recipients. The long-term prognostic value of serial CFR quantification by PET imaging in HT patients is unknown. A total of 89 patients with history of HT (71% men, 7.0 ± 5.7 years post-HT, age 57 ± 11 years) scheduled for dynamic rest and stress (dipyridamole) 82Rb PET between March 1, 2008 and July 31, 2009 (PET-1) were prospectively enrolled in a single-center study. PET myocardial perfusion studies were reprocessed using U.S. Food and Drug Administration-approved software (Corridor 4DM, version 2017) for calculation of CFR. Follow-up PET (PET-2) imaging was performed in 69 patients at 1.9 ± 0.3 years following PET-1. Patients were categorized based on CFR values considering CFR ≤1.5 as low and CFR >1.5 as high CFR. Forty deaths occurred during the median follow-up time of 8.6 years. Low CFR at PET-1 was associated with a 2.77-fold increase in all-cause mortality (95% confidence interval [CI]: 1.34 to 5.74; p = 0.004). CFR decreased over time in patients with follow-up imaging (PET-1: 2.11 ± 0.74 vs. PET-2: 1.81 ± 0.61; p = 0.003). Twenty-five patients were reclassified based on PET-1 and PET-2 (high to low CFR: n = 18, low to high CFR: n = 7). Overall survival was similar in patients reclassified from high to low as patients with low to low CFR, whereas patients reclassified from low to high had similar survival as patients with high to high CFR. In multivariate Cox regression of patients with PET-2, higher baseline CFR (hazard ratio [HR] for a 0.73 unit (one standard deviation) increase: 0.36, 95% CI: 0.16 to 0.82) and reduction in CFR from PET-1 to PET-2 (HR for a 0.79 unit (one standard deviation) decrease: 1.50 to 7.84) were independent predictors of all-cause mortality. Serial assessment of CFR by 82Rb PET independently predicts long-term mortality in HT patients.
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影响因子：
14
作者：
Kitkungvan, Danai;Johnson, Nils P.;Gould, K. Lance
通讯作者：
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影响因子：
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作者：
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DOI：
10.1007/s00259-007-0478-2
发表时间：
2007-11-01
影响因子：
9.1
作者：
Lortie, Mireille;Beanlands, Rob S. B.;dekemp, Robert A.
通讯作者：
dekemp, Robert A.