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Lu Y, Meng J, Yun M, Hacker M, Li X, Zhang X. Reduced hematopoietic-inflammatory response and worse outcomes in patients with recurrent myocardial infarction in comparison with primary myocardial infarction. EJNMMI Res 2023; 13:85. [PMID: 37749412 PMCID: PMC10519922 DOI: 10.1186/s13550-023-01035-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/19/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Recurrent myocardial infarction (RMI) portends an unfavorable outcome, which might be related to diminished hematopoietic-inflammatory activation. We aimed to investigate the hematopoietic-inflammatory activation and the outcome in categorized patients with primary myocardial infarction (PMI) versus RMI as well as chronic stable angina (CSA) by 18F-FDG PET. RESULTS A total of 105 patients (88 males; 60.1 ± 9.7 years) were included. Target-to-background ratio of bone marrow (TBRBM) was highest in the PMI group (n = 45), intermediate in the RMI group (n = 30), and lowest in the CSA group (n = 30) (P < 0.001). RMI group exhibited larger scar, significantly reduced left ventricular ejection fraction, and enlarged end systolic volume in comparison with the PMI and CSA groups, respectively (P < 0.05). Additionally, there was a significantly positive correlation between TBRBM and TBRaorta (P < 0.001). The cumulative major adverse cardiac events free survival of patients in the RMI group was lower than that in the PMI and CSA groups during a median follow-up of 16.6 months (P = 0.026). CONCLUSIONS RMI conferred relatively decreased hematopoietic-inflammatory activation compared with PMI. Patients with RMI presented subsequent enlarged myocardial scar, worsened cardiac dysfunction, aggravated remodeling, and worse outcomes than that in PMI patients.
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Affiliation(s)
- Yao Lu
- Department of Nuclear Medicine, Molecular Imaging Lab, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jingjing Meng
- Department of Nuclear Medicine, Molecular Imaging Lab, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Mingkai Yun
- Department of Nuclear Medicine, Molecular Imaging Lab, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Xiang Li
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
| | - Xiaoli Zhang
- Department of Nuclear Medicine, Molecular Imaging Lab, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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Metformin confers longitudinal cardiac protection by preserving mitochondrial homeostasis following myocardial ischemia/reperfusion injury. Eur J Nucl Med Mol Imaging 2023; 50:825-838. [PMID: 36322187 DOI: 10.1007/s00259-022-06008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Myocardial ischemia-reperfusion (I/R) injury is associated with systemic oxidative stress, cardiac mitochondrial homeostasis, and cardiomyocyte apoptosis. Metformin has been recognized to attenuate cardiomyocyte apoptosis. However, the longitudinal effects and pathomechanism of metformin on the regulation of myocardial mitohormesis following I/R treatment remain unclear. This study aimed to investigate the longitudinal effects and mechanism of metformin in regulating cardiac mitochondrial homeostasis by serial imaging with the 18-kDa translocator protein (TSPO)-targeted positron emission tomography (PET) tracer 18F-FDPA. METHODS Myocardial I/R injury was established in Sprague-Dawley rats, which were treated with or without metformin (150 mg/kg per day). Serial gated 18F-FDG and 18F-FDPA PET imaging were performed at 1, 4, and 8 weeks after surgery, followed by analysis of ventricular remodelling and cardiac mitochondrial homeostasis. The correlation between Hsp60 and 18F-FDPA uptake was analyzed. After PET imaging, the activity of antioxidant enzymes, immunostaining, and western blot analysis were performed to analyze the spatio-temporal effects and pathomechanism of metformin for cardiac protection after myocardial I/R injury. RESULTS Oxidative stress and apoptosis increased 1 week after myocardial I/R injury (before significant progression of ventricular remodelling). TSPO expression was correlated with Hsp60 expression and was co-localized with inflammatory CD68+ macrophages in the infarct area, and TSPO uptake was associated with an upregulation of AMPK-p/AMPK and a downregulation of Bcl-2/Bax. However, these effects were reversed with metformin treatment. Eight weeks after myocardial I/R injury (representing the advanced stage of heart failure), 18F-FDPA uptake in myocardial cells in the distal non-infarct area increased without CD68+ expression, whereas the activity decreased with metformin treatment. CONCLUSION Taken together, these results show that a prolonged metformin treatment has pleiotropic protective effects against myocardial I/R injury associated with a regional and temporal dynamic balance between mitochondrial homeostasis and cardiac outcome, which were assessed by TSPO-targeted imaging during cardiac remodelling.
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Lu X, Zhao M, Tian C, Wei H, Gao M, Yang X, Zhang X, Li X. Prognostic value of ventricular mechanical dyssynchrony in patients with left ventricular aneurysm: A comparative study of medical and surgical treatment. J Nucl Cardiol 2022; 29:652-660. [PMID: 32909240 DOI: 10.1007/s12350-020-02343-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/11/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The prognostic value of left ventricular (LV) mechanical dyssynchrony (MD) in patients with LV aneurysm (LVA) is unclear. This study aimed to investigate the long-term prognostic value of LVMD in LVA patients. METHODS 92 consecutive patients who underwent 99mTc-sestamibi-gated SPECT myocardial perfusion imaging (GSPECT) were retrospectively analyzed and followed-up for a median of 63 months (range, 1-73 months). LV function and histogram bandwidth (BW) were analyzed by QGS software. LVMD was defined by ROC analysis. Cardiac death was defined as the primary endpoint, and the composite of cardiac deaths and severe or acute heart failure (MACE) as the secondary endpoint. RESULTS The annual cardiac mortality rate of LVA patients with LVMD and treated by surgical therapy was significantly lower than those treated by medical therapy (2.40% vs. 6.40%, P < .05) but not annual MACE rate (6.61% vs. 10.06%, P > .05). In patients without LVMD, no significant difference in survival and MACE-free survival between medical and surgical treatment. In addition, the occurrence of LVMD is related to the worsen cardiac outcome in terms of MACE and cardiac death, independent of the treatment methods. BW was an independent predictor for MACE (HR 1.010, P < .01) and LVEF (HR .928, P < .05) was an independent predictor for cardiac death in all LVA patients. CONCLUSIONS LVA patients with LVMD might be associated with high risk for cardiac death and surgical treatment might improve cardiac survival compared to medical therapy in these patients.
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Affiliation(s)
- Xia Lu
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, No. 2, Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Min Zhao
- Department of Nuclear Medicine, Zibo Central Hospital, Zibo, Shandong Province, China
| | - Congna Tian
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, Hebei Province, China
| | - Hongxing Wei
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, and National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingxin Gao
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiubin Yang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaoli Zhang
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, No. 2, Anzhen Road, Chaoyang District, Beijing, 100029, China.
| | - Xiang Li
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, No. 2, Anzhen Road, Chaoyang District, Beijing, 100029, China
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
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Yun M, Nie B, Wen W, Zhu Z, Liu H, Nie S, Lanzenberger R, Wei Y, Hacker M, Shan B, Schelbert HR, Li X, Zhang X. Assessment of cerebral glucose metabolism in patients with heart failure by 18F-FDG PET/CT imaging. J Nucl Cardiol 2022; 29:476-488. [PMID: 32691347 DOI: 10.1007/s12350-020-02258-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/10/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND To evaluate the cerebral metabolism in patients with heart failure (HF). METHODS One hundred and two HF patients were prospectively enrolled, who underwent gated 99mTc-sestamibi single photon emission computed tomography (SPECT)/CT, cardiac and cerebral 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT. Fifteen healthy volunteers served as controls. Patients were stratified by extent of hibernating myocardium (HM) and left ventricular ejection fraction (LVEF) into 4 groups where Group1: HM < 10% (n = 33); Group2: HM ≥ 10%, LVEF < 25% (n = 34); Group3: HM ≥ 10%, 25% ≤ LVEF ≤ 40% (n = 16) and Group 4: LVEF > 40% (n = 19). The standardized uptake value (SUV) in the whole brain (SUVwhole-brain) and the SUV ratios (SUVR) in 24 cognition-related brain regions were determined. SUVwhole-brain and SUVRs were compared between the 4 patient groups and the healthy controls. RESULTS SUVwhole-brain (r = 0.245, P = 0.013) and SUVRs in frontal areas, hippocampus, and para-hippocampus (r: 0.213 to 0.308, all P < 0.05) were correlated with HM. SUVwhole-brain differed between four patient groups and the healthy volunteers (P = 0.016) and SUVwhole-brain in Group 1 was lower than that in healthy volunteers (P < 0.05). SUVRs of Group 3 in frontal areas were the highest among four patient subgroups (P < 0.05). CONCLUSIONS Cerebral metabolism in the whole brain was reduced but maintained in cognition-related frontal areas in HF patients with HM and moderately impaired global left ventricular function.
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Affiliation(s)
- Mingkai Yun
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Upper Airway Dysfunction and Related Cardiovascular Diseases, Beijing, China
| | - Binbin Nie
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Wanwan Wen
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Upper Airway Dysfunction and Related Cardiovascular Diseases, Beijing, China
| | - Ziwei Zhu
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Upper Airway Dysfunction and Related Cardiovascular Diseases, Beijing, China
| | - Hua Liu
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Shaoping Nie
- Beijing Key Laboratory of Upper Airway Dysfunction and Related Cardiovascular Diseases, Beijing, China
- Division of Emergency & Critical Care Centre, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Rupert Lanzenberger
- Neuroimaging Labs (NIL), Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Yongxiang Wei
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Upper Airway Dysfunction and Related Cardiovascular Diseases, Beijing, China
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Baoci Shan
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Heinrich R Schelbert
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Xiang Li
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Xiaoli Zhang
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Upper Airway Dysfunction and Related Cardiovascular Diseases, Beijing, China.
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Lu Y, Tian Y, Mou T, Zhou Y, Tian J, Yun M, Kiss A, Podesser BK, Hacker M, Zhang X, Li X. Transient cardioprotective effects of remote ischemic postconditioning on non-reperfused myocardial infarction: longitudinal evaluation study in pigs. Int J Cardiol 2022; 355:37-43. [DOI: 10.1016/j.ijcard.2022.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 11/25/2022]
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Mpanya D, Ayeni A, More S, Hadebe B, Sathekge M, Tsabedze N. The clinical utility of 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography in guiding myocardial revascularisation. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00454-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Ning X, Yang Z, Ye X, Si Y, Wang F, Zhang X, Zhang S. Impact of revascularization in patients with post-infarction left ventricular aneurysm and ventricular tachyarrhythmia. Ann Noninvasive Electrocardiol 2020; 26:e12814. [PMID: 33368864 PMCID: PMC7935102 DOI: 10.1111/anec.12814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/17/2020] [Accepted: 10/08/2020] [Indexed: 11/27/2022] Open
Abstract
Background Ventricular arrhythmia is a leading cause of cardiac death among patients with post‐infarction left ventricular aneurysm (PI‐LVA). The effect of coronary revascularization in PI‐LVA patients with ventricular tachyarrhythmia remains unknown. This study aims to investigate the impact of revascularization therapy on clinical outcomes in these patients. Methods A total of 238 PI‐LVA patients were enrolled, and 59 patients were presented with sustained ventricular tachycardia (VT) or ventricular fibrillation (VF). Patients were classified into 4 groups by treatment strategies (medical or revascularization) and the presence of VT/VF: group 1 (n = 57): VT/VF− and revascularization−; group 2 (n = 122): VT/VF− and revascularization+; group 3 (n = 34): VT/VF+ and revascularization+; and group 4 (n = 25): VT/VF+ and revascularization‐. The clinical outcomes were compared, and the primary endpoint was cardiac death or heart transplantation. Results Patients were followed up for 45 ± 16 months, and 41 patients (17.2%) reached the primary endpoint. Kaplan–Meier analysis showed that in VT/VF− patients, revascularization associated with higher cardiac survival compared with medical therapy (log‐rank p = .002), but in VT/VF+ patients, revascularization did not predict better cardiac outcome (log‐rank p = .901). Cox regression analysis revealed PET‐EF (HR 4.41, 95% CI: 1.72–11.36, p = .002) and moderate/severe mitral regurgitation (HR 2.32, 95% CI: 1.02–5.30, p = .046) as independent predictors of adverse cardiac outcome in patients with VT/VF. Conclusion PI‐LVA patients with VT/VF are at high risk of adverse cardiac outcome, and coronary revascularization does not mitigate this risk, although revascularization was associated with higher cardiac survival in PI‐LVA patients without VT/VF.
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Affiliation(s)
- Xiaohui Ning
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zihe Yang
- Department of Nuclear Medicine, Capital Medical University Affiliated Anzhen Hospital, Beijing, China
| | - Xuerui Ye
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanhua Si
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoli Zhang
- Department of Nuclear Medicine, Capital Medical University Affiliated Anzhen Hospital, Beijing, China
| | - Shu Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Lv Y, Lv X, Liu W, Judenhofer MS, Zwingenberger A, Wisner E, Berg E, McKenney S, Leung E, Spencer BA, Cherry SR, Badawi RD. Mini EXPLORER II: a prototype high-sensitivity PET/CT scanner for companion animal whole body and human brain scanning. Phys Med Biol 2019; 64:075004. [PMID: 30620929 DOI: 10.1088/1361-6560/aafc6c] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
As part of the EXPLORER total-body positron emission tomography (PET) project, we have designed and built a high-resolution, high-sensitivity PET/CT scanner, which is expected to have excellent performance for companion animal whole body and human brain imaging. The PET component has a ring diameter of 52 cm and an axial field of view of 48.3 cm. The detector modules are composed of arrays of lutetium (yttrium) oxyorthosilicate (LYSO) crystals of dimensions 2.76 × 2.76 × 18.1 mm3 coupled to silicon photomultipliers (SiPMs) for read-out. The CT component is a 24 detector row CT scanner with a 50 kW x-ray tube. PET system time-of-flight resolution was measured to be 409 ± 39 ps and average system energy resolution was 11.7% ± 1.5% at 511 keV. The NEMA NU2-2012 system sensitivity was found to be 52-54 kcps MBq-1. Spatial resolution was 2.6 mm at 10 mm from the center of the FOV and 2.0 mm rods were clearly resolved on a mini-Derenzo phantom. Peak noise-equivalent count (NEC) rate, using the NEMA NU 2-2012 phantom, was measured to be 314 kcps at 9.2 kBq cc-1. The CT scanner passed the technical components of the American College of Radiology (ACR) accreditation tests. We have also performed scans of a Hoffman brain phantom and we show images from the first canine patient imaged on this device.
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Affiliation(s)
- Yang Lv
- Molecular Imaging Business Unit, Shanghai United Imaging Healthcare, Co. Ltd., Shanghai, People's Republic of China
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Ning X, Ye X, Si Y, Yang Z, Zhao Y, Sun Q, Chen R, Tang M, Chen K, Zhang X, Zhang S. Prevalence and prognosis of ventricular tachycardia/ventricular fibrillation in patients with post-infarction left ventricular aneurysm: Analysis of 575 cases. J Electrocardiol 2018; 51:742-746. [PMID: 29803411 DOI: 10.1016/j.jelectrocard.2018.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/12/2018] [Accepted: 03/21/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND We investigated the prevalence of ventricular tachycardia/ventricular fibrillation (VT/VF) in Post-infarction left ventricular aneurysm (PI-LVA) patients and analyze clinical outcomes in patients presenting with VT/VF. METHODS 575 PI-LVA patients were enrolled and investigated by logistic regression analysis. Patients with VT/VF were followed up, the composite primary endpoint was cardiac death and appropriate ICD/external shocks. RESULTS The incidence of sustained VT/VF was 11%. Logistical regression analysis showed male gender, enlarged LV end diastolic diameter (LVEDD) and higher NYHA class were correlated with VT/VF development. During follow up of 46 ± 15 months, 19 out of 62(31%) patients reached study end point. Multivariate Cox regression analysis revealed that enlarged LVEDD and moderate/severe mitral regurgitation (MR) were independently predictive of clinical outcome. CONCLUSIONS Male gender, enlarged LVEDD and higher NYHA class associated with risk of sustained VT/VF in PI-LVA patients. Among VT/VF positive patients, enlarged LVEDD and moderate/severe MR independently predicted poor clinical prognosis.
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Affiliation(s)
- Xiaohui Ning
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Xuerui Ye
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Yanhua Si
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Zihe Yang
- Department of Nuclear Medicine, Anzhen Hospital, China
| | - Yunzi Zhao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Qi Sun
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Ruohan Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Min Tang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Keping Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Xiaoli Zhang
- Department of Nuclear Medicine, Anzhen Hospital, China
| | - Shu Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China.
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Cardiac death in patients with left ventricular aneurysm, remodeling and myocardial viability by gated 99mTc-MIBI SPECT and gated 18F-FDG PET. Int J Cardiovasc Imaging 2017; 34:485-493. [DOI: 10.1007/s10554-017-1234-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/10/2017] [Indexed: 10/19/2022]
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Zhang X, Yang Y, Wei H, Tian Y, Shi H, Wang Y, Li S, He ZX, Li Y, Liu XJ. State and Recent Progress of Nuclear Cardiology in China. CURRENT CARDIOVASCULAR IMAGING REPORTS 2015. [DOI: 10.1007/s12410-015-9332-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Orlandini A, Castellana N, Pascual A, Botto F, Cecilia Bahit M, Chacon C, Luz Diaz M, Diaz R. Myocardial viability for decision-making concerning revascularization in patients with left ventricular dysfunction and coronary artery disease: A meta-analysis of non-randomized and randomized studies. Int J Cardiol 2015; 182:494-9. [DOI: 10.1016/j.ijcard.2015.01.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 12/31/2014] [Accepted: 01/05/2015] [Indexed: 10/24/2022]
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Wei H, Tian C, Schindler TH, Qiu M, Lu M, Shen R, Tian Y, Zhao SH, Zhang X. The impacts of severe perfusion defects, akinetic/dyskinetic segments, and viable myocardium on the accuracy of volumes and LVEF measured by gated ⁹⁹mTc-MIBI SPECT and gated ¹⁸F-FDG PET in patients with left ventricular aneurysm: cardiac magnetic resonance imaging as the reference. J Nucl Cardiol 2014; 21:1230-44. [PMID: 25189143 DOI: 10.1007/s12350-014-9978-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND To compare the accuracy of end-diastolic and end-systolic volumes (EDV, ESV) and LV ejection fraction (LVEF) measured by both GSPECT and GPET, using cardiac magnetic resonance imaging (CMR) as a reference. Furthermore, the impacts of severe perfusion defects, akinetic/dyskinetic segments, and residual viable myocardium on the accuracy of LV functional parameters were investigated. METHODS Ninety-six consecutive patients with LV aneurysm and LV dysfunction (LVEF 32 ± 9%) diagnosed by CMR were studied with GSPECT and GPET. EDV, ESV, and LVEF were calculated using QGS software. RESULTS Correlations of volumes were excellent (r 0.81-0.86) and correlation of LVEF was moderate (r 0.65-0.76) between GSPECT vs CMR and between GPET vs CMR. Compared with CMR, ESV was overestimated by GSPECT (P < .01) and underestimated by GPET (P < .0001); EDV was underestimated by GPET (P < .001); LVEF was underestimated by GSPECT but overestimated by GPET (both P < .001). Multivariate regression analysis revealed that the number of segments with severe perfusion defects (P < .001) was the only independent factor which was correlated to the EDV difference between GSPECT and CMR, the number of akinetic/dyskinetic segments with absent wall thickening (WT) was the only independent factor which was significantly correlated to the differences of ESV and LVEF measurements between GSPECT vs CMR and between GPET vs CMR (P < .0001), respectively. Neither the mismatch score nor the segments with viable myocardium were correlated to the differences of LV volumes and LVEF measurements between different imaging modalities. CONCLUSIONS In LV aneurysm patients, LV volumes and LVEF measured by both GSPECT and GPET imaging correlated well with those determined by CMR, but should not be interchangeable in individual patients. The accuracy of LVEF measured by GSPECT and GPET was affected by the akinetic/dyskinetic segments with absent WT.
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Affiliation(s)
- Hongxing Wei
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10037, People's Republic of China
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Abstract
Positron Emission Tomography (PET) has several clinical and research applications in cardiovascular imaging. Myocardial perfusion imaging with PET allows accurate global and regional measurements of myocardial perfusion, myocardial blood flow and function at stress and rest in one exam. Simultaneous assessment of function and perfusion by PET with quantitative software is currently the routine practice. Combination of ejection fraction reserve with perfusion information may improve the identification of severe disease. The myocardial viability can be estimated by quantitative comparison of fluorodeoxyglucose (18FDG) and rest perfusion imaging. The myocardial blood flow and coronary flow reserve measurements are becoming routinely included in the clinical assessment due to enhanced dynamic imaging capabilities of the latest PET/CT scanners. Absolute flow measurements allow evaluation of the coronary microvascular dysfunction and provide additional prognostic and diagnostic information for coronary disease. Standard quantitative approaches to compute myocardial blood flow from kinetic PET data in automated and rapid fashion have been developed for 13N-ammonia, 15O-water and 82Rb radiotracers. The agreement between software methods available for such analysis is excellent. Relative quantification of 82Rb PET myocardial perfusion, based on comparisons to normal databases, demonstrates high performance for the detection of obstructive coronary disease. New tracers, such as 18F-flurpiridaz may allow further improvements in the disease detection. Computerized analysis of perfusion at stress and rest reduces the variability of the assessment as compared to visual analysis. PET quantification can be enhanced by precise coregistration with CT angiography. In emerging clinical applications, the potential to identify vulnerable plaques by quantification of atherosclerotic plaque uptake of 18FDG and 18F-sodium fluoride tracers in carotids, aorta and coronary arteries has been demonstrated.
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Cui M, Ono M, Kimura H, Liu B, Saji H. Novel quinoxaline derivatives for in vivo imaging of β-amyloid plaques in the brain. Bioorg Med Chem Lett 2011; 21:4193-6. [DOI: 10.1016/j.bmcl.2011.05.079] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 05/20/2011] [Accepted: 05/23/2011] [Indexed: 11/29/2022]
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Inaba Y, Chen JA, Bergmann SR. Quantity of viable myocardium required to improve survival with revascularization in patients with ischemic cardiomyopathy: A meta-analysis. J Nucl Cardiol 2010; 17:646-54. [PMID: 20379861 DOI: 10.1007/s12350-010-9226-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Accepted: 03/15/2010] [Indexed: 12/17/2022]
Abstract
BACKGROUND This meta-analysis was conducted to determine optimal cutoff values for the assessment of viability using various imaging techniques for which revascularization would offer a survival benefit in patients with ischemic cardiomyopathy (ICM). METHODS AND RESULTS We searched five electronic databases to identify relevant studies through December 2008. Relative risks of cardiac death, both in patients with and without viability, were calculated in each study. In order to estimate the optimal threshold for the presence of viability, we assumed a linear relationship between the amount of viable myocardium and survival benefit of revascularization. Twenty-nine studies (4,167 patients) met the inclusion criteria. The optimal threshold for the presence of viability was estimated to be 25.8% (95% CI: 16.6-35.0%) by positron emission tomography using 18F-fluorodeoxyglucose-perfusion mismatch, 35.9% (95% CI: 31.6-40.3%) by stress echocardiography using contractile reserve or ischemic responses, and 38.7% (95% CI: 27.7-49.7%) by single photon emission computed tomography using thallium-201 or technetium-99m MIBI myocardial perfusion. CONCLUSIONS The calculated amount of viable myocardium determined to lead to improved survival was different among imaging techniques. Thus, separate cutoff values for imaging modalities may be helpful in determining which patients with ICM benefit from revascularization.
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Affiliation(s)
- Yoichi Inaba
- Division of Cardiovascular Medicine, Oregon Health and Science University, UHN62, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
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Marinelli M, Martinez-Möller A, Jensen B, Positano V, Weismüller S, Navab N, Landini L, Schwaiger M, Nekolla SG. Registration of myocardial PET and SPECT for viability assessment using mutual information. Med Phys 2010; 37:2414-24. [DOI: 10.1118/1.3395554] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Candell-Riera J, Romero-Farina G, Aguadé-Bruix S, Castell-Conesa J. Ischemic cardiomyopathy: a clinical nuclear cardiology perspective. Rev Esp Cardiol 2009; 62:903-17. [PMID: 19706246 DOI: 10.1016/s1885-5857(09)72655-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ischemic cardiomyopathy results from severe extensive coronary artery disease, which is associated with left ventricular dysfunction and also, in many cases, with significant left ventricular dilatation. Mortality is high, especially in patients who satisfy myocardial viability criteria but who have not undergone revascularization. Although age, exercise capacity and comorbidity influence survival, the most important prognostic factors are the extent of the ischemia, myocardial viability and left ventricular remodeling, all of which can be successfully evaluated by gated myocardial perfusion single-photon emission computed tomography (SPECT).
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Affiliation(s)
- Jaume Candell-Riera
- Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Achenbach S, Dilsizian V, Kramer CM, Zoghbi WA. The Year in Coronary Artery Disease. JACC Cardiovasc Imaging 2009; 2:774-86. [DOI: 10.1016/j.jcmg.2009.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 01/16/2009] [Indexed: 01/13/2023]
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