Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis.
Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis.
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DOI：
10.1016/j.jacc.2013.09.022
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发表时间：
2014-02-04
影响因子：
24
通讯作者：
Di Carli, Marcelo F.
中科院分区：
文献类型：
--
作者：
Blankstein, Ron;Osborne, Michael;Naya, Masanao;Waller, Alfonso;Kim, Chun K.;Murthy, Venkatesh L.;Kazemian, Pedram;Kwong, Raymond Y.;Tokuda, Michifumi;Skali, Hicham;Padera, Robert;Hainer, Jon;Stevenson, William G.;Dorbala, Sharmila;Di Carli, Marcelo F.
我们试图将PET的影像学表现与转诊评估已知或疑似心脏结节病（CS）患者的不良心脏事件联系起来。尽管心脏正电子发射断层扫描（PET）常用于评估疑似CS患者，但PET结果与临床结局之间的关系尚未报道。我们研究了118例无CAD病史的连续患者，这些患者在高脂肪/低碳水化合物饮食抑制正常心肌葡萄糖摄取后，使用18 F-氟脱氧葡萄糖（FDG）[评估炎症]和82铷[评估灌注缺陷（PD）]进行PET。PET数据的盲读将心脏发现分类为（a）正常;（B）阳性PD或FDG;（c）阳性PD和FDG。还使用图像来确定是否存在心外结节病的结果。不良事件（AE）-死亡或持续性室性心动过速（VT）-通过电子病历、除颤器询问、患者问卷调查和电话访谈来确定。在118例患者中（年龄52±11岁;男性57%，平均射血分数47%±16%），47例（40%）心脏PET结果正常，71例（60%）异常。在平均1.5年的随访中，有31例（26%）不良事件（27例VT和8例死亡）。心脏PET结果预测AE，PD和异常FDG（29%的患者）的存在与3.9的风险比（p<0.01）相关，并且在调整左心室射血分数（LVEF）和临床标准后仍显着。心外FDG摄取（26%的患者）与AE无关。心脏PET上局灶性PD和FDG摄取的存在可识别死亡或VT风险较高的患者。这些发现提供了超出日本临床标准的预后价值，即心外结节病和LVEF的存在。
We sought to relate imaging findings on PET to adverse cardiac events in patients referred for evaluation of known or suspected cardiac sarcoidosis (CS). Although cardiac positron emission tomography (PET) is commonly used to evaluate patients with suspected CS, the relationship between PET findings and clinical outcomes has not been reported. We studied 118 consecutive patients with no history of CAD who were referred for PET using 18F-fluorodeoxyglucose (FDG) [to assess for inflammation] and 82Rubidium [to evaluate for perfusion defects (PD)] following a high fat / low carbohydrate diet to suppress normal myocardial glucose uptake. Blind reads of the PET data categorized cardiac findings as (a) normal; (b) positive PD or FDG; (c) positive PD and FDG. Images were also used to identify if findings for extra cardiac sarcoidosis were present. Adverse events (AE) -- death or sustained ventricular tachycardia (VT) -- were ascertained by electronic medical records, defibrillator interrogation, patient questionnaires and phone interviews. Among the 118 patients (age 52±11; males 57%, mean ejection fraction 47%±16%), 47 (40%) had normal and 71 (60%) abnormal cardiac PET findings. Over a median follow-up of 1.5 years, there were 31 (26%) adverse events (27 VT and 8 deaths). Cardiac PET findings were predictive of AE with the presence of both a PD and abnormal FDG (29% of patients) being associated with hazard ratio of 3.9 (p<0.01) and remaining significant after adjusting for left ventricular ejection fraction (LVEF) and clinical criteria. Extra-cardiac FDG uptake (26% of patients) was not associated with AE. The presence of focal PD and FDG uptake on cardiac PET identifies patients at higher risk of death or VT. These findings offer prognostic value beyond Japanese clinical criteria, the presence of extra cardiac sarcoidosis and LVEF.
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DOI：
10.1111/j.1540-8167.2012.02350.x
发表时间：
2012-09-01
影响因子：
2.7
作者：
Schuller, Joseph L.;Zipse, Matthew;Sauer, William H.
通讯作者：
Sauer, William H.
影响因子：
39.3
作者：
Ishimaru, S;Tsujino, I;Nishimura, M
通讯作者：
Nishimura, M
影响因子：
37.8
作者：
Patel MR;Cawley PJ;Heitner JF;Klem I;Parker MA;Jaroudi WA;Meine TJ;White JB;Elliott MD;Kim HW;Judd RM;Kim RJ
通讯作者：
Kim RJ
DOI：
10.1046/j.1460-9592.2003.t01-1-00217.x
发表时间：
2003-07-01
影响因子：
1.8
作者：
Ott, P;Marcus, FI;Fuenzalida, CE
通讯作者：
Fuenzalida, CE
影响因子：
37.8
作者：
SILVERMAN, KJ;HUTCHINS, GM;BULKLEY, BH
通讯作者：
BULKLEY, BH