Prognostic value of myocardial flow reserve derived by quantitative SPECT for patients with intermediate coronary stenoses
© 2023. The Author(s) under exclusive licence to American Society of Nuclear Cardiology..
BACKGROUND: Functional assessment of myocardial ischemia is critical for patients with intermediate coronary stenosis. As the diagnosis performance of absolute quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) by single-photon emission tomography (SPECT) has been proven, its prognostic value in patients with intermediate coronary stenosis remains to be evaluated.
METHODS: Patients with one or more target lesions of ≥ 50% to ≤ 80% diameter stenoses on invasive coronary angiography were prospectively included in this study. All patients were scheduled for clinically indicated SPECT myocardial perfusion imaging (MPI) within 3 months and agreed to provide informed consent to participate in quantitative SPECT acquisitions to obtain MBF and MFR values. The primary endpoint was defined as a composite of the major adverse cardiac events (MACE): Cardiac death, myocardial infarction, late revascularization and heart failure or unstable angina-related rehospitalization.
RESULTS: One hundred and nineteen patients (mean age 57 ± 8 years, 62.2% men) were included in the analysis. The average lumen stenosis of patients was 67.0 ± 10.4%. Over a median follow-up duration of 1408 days (interquartile range 1297-1666 days), 18 patients (15.1%) had MACE. Patients with impaired MFR (MFR < 2) had a significantly higher incidence of events than those with preserved MFR (MFR ≥ 2) in Kaplan-Meier survival analysis (Log-rank = 8.105, P = 0.004), while no significant difference was found between patients with normal relative perfusion and those with relative perfusion abnormalities (log-rank = 0.098, P > 0.05). In a multivariate Cox hazards analysis, the SPECT-derived MFR remained an independent predictor of MACE (HR 0.352, 95% CI 0.145-0.854, P = 0.021).
CONCLUSIONS: In a cohort of patients with angiographic intermediate coronary lesions, SPECT-derived MFR was an independent predictor of prognosis.
| Errataetall: |
CommentIn: J Nucl Cardiol. 2023 Aug;30(4):1437-1442. - PMID 37160851 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology - 30(2023), 4 vom: 29. Aug., Seite 1427-1436 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sun, Ruoxi [VerfasserIn] |
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| Links: |
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| Themen: |
Intermediate coronary stenosis |
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| Anmerkungen: |
Date Completed 28.07.2023 Date Revised 30.01.2024 published: Print-Electronic CommentIn: J Nucl Cardiol. 2023 Aug;30(4):1437-1442. - PMID 37160851 Citation Status MEDLINE |
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| doi: |
10.1007/s12350-022-03186-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM351046372 |
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| 245 | 1 | 0 | |a Prognostic value of myocardial flow reserve derived by quantitative SPECT for patients with intermediate coronary stenoses |
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| 500 | |a Date Revised 30.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Nucl Cardiol. 2023 Aug;30(4):1437-1442. - PMID 37160851 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s) under exclusive licence to American Society of Nuclear Cardiology. | ||
| 520 | |a BACKGROUND: Functional assessment of myocardial ischemia is critical for patients with intermediate coronary stenosis. As the diagnosis performance of absolute quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) by single-photon emission tomography (SPECT) has been proven, its prognostic value in patients with intermediate coronary stenosis remains to be evaluated | ||
| 520 | |a METHODS: Patients with one or more target lesions of ≥ 50% to ≤ 80% diameter stenoses on invasive coronary angiography were prospectively included in this study. All patients were scheduled for clinically indicated SPECT myocardial perfusion imaging (MPI) within 3 months and agreed to provide informed consent to participate in quantitative SPECT acquisitions to obtain MBF and MFR values. The primary endpoint was defined as a composite of the major adverse cardiac events (MACE): Cardiac death, myocardial infarction, late revascularization and heart failure or unstable angina-related rehospitalization | ||
| 520 | |a RESULTS: One hundred and nineteen patients (mean age 57 ± 8 years, 62.2% men) were included in the analysis. The average lumen stenosis of patients was 67.0 ± 10.4%. Over a median follow-up duration of 1408 days (interquartile range 1297-1666 days), 18 patients (15.1%) had MACE. Patients with impaired MFR (MFR < 2) had a significantly higher incidence of events than those with preserved MFR (MFR ≥ 2) in Kaplan-Meier survival analysis (Log-rank = 8.105, P = 0.004), while no significant difference was found between patients with normal relative perfusion and those with relative perfusion abnormalities (log-rank = 0.098, P > 0.05). In a multivariate Cox hazards analysis, the SPECT-derived MFR remained an independent predictor of MACE (HR 0.352, 95% CI 0.145-0.854, P = 0.021) | ||
| 520 | |a CONCLUSIONS: In a cohort of patients with angiographic intermediate coronary lesions, SPECT-derived MFR was an independent predictor of prognosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Myocardial blood flow | |
| 650 | 4 | |a intermediate coronary stenosis | |
| 650 | 4 | |a myocardial flow reserve | |
| 650 | 4 | |a myocardial perfusion imaging | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a single-photon emission computed tomography | |
| 700 | 1 | |a Ma, Rongzheng |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Meng |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Kai |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Zongyao |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Lei |e verfasserin |4 aut | |
| 700 | 1 | |a Fang, Wei |e verfasserin |4 aut | |
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