Evidence map›Paper›PMID 24482141›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2014

Prognostic significance of impaired chronotropic response to pharmacologic stress Rb-82 PET.

Naveen Bellam, Emir Veledar, Sharmila Dorbala, Marcelo F Di Carli, Sana Shah, Danny Eapen, Arshed Quyyumi, Rob S B Beanlands, Michael E Merhige, Brent A Williams and 4 more

Abstract read
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In one paragraph

Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed.

  1. Prognostic value of heart rate response during regadenoson stress myocardial perfusion imaging in patients with end stage renal disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016
    Trial
  2. Downward myocardial creep during stress PET imaging is inversely associated with mortality.European journal of nuclear medicine and molecular imaging · 2024
    Article
  3. Review
  4. Review of cardiovascular imaging in the Journal of Nuclear Cardiology in 2017. Part 2 of 2: Myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018
    Review
  5. The heart rate response to regadenoson in patients with atrial fibrillation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018
    Article
  6. Observational
  7. The blood pressure response to vasodilator stress does not provide independent prognostic information.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
    Article
  8. Prognostic significance of blood pressure response during vasodilator stress Rb-82 positron emission tomography myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
    Article
  9. Review of cardiovascular imaging in the journal of nuclear cardiology in 2016: Part 2 of 2-myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
    Review
  10. Clinical value of hyperemic left ventricular systolic function in vasodilator stress testing.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
    Review
  11. Article
  12. The benefits of advanced risk reclassification.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016
    Article
  13. Heart rate response to regadenoson: Making the case for its value in clinical practice.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016
    Article
  14. The prognostic value of non-perfusion variables obtained during vasodilator stress myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016
    Review
  15. Article
  16. Review
  17. Review
  18. The importance of heart rate response during myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Naveen BellamEmory Clinical Cardiovascular Research Institute, Emory University School of Medicine, 1462 Clifton Road NE, Room 529, Atlanta, GA, 30324, USA.
Emir Veledar
Sharmila Dorbala
Marcelo F Di Carli
Sana Shah
Danny Eapen
Arshed Quyyumi
Rob S B Beanlands
Michael E Merhige
Brent A Williams
Benjamin J W Chow
James K Min
Daniel S Berman
Leslee J Shaw

Funding

Prognostic Utility of Absolute Coronary Microvascular Function by PET/CTK23HL092299 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI DORBALA, SHARMILA · 2009 to 2013
$705k
NHLBI NIH HHS K23HL092299
6 · The paper itself

Abstract

backgroundAn impaired chronotropic response to exercise is an accepted risk marker but the relationship between heart rate reserve (HRR) with pharmacologic stress is less well-established. The primary aim of this analysis was to evaluate the prognostic significance of HRR in patients undergoing rest/stress myocardial perfusion positron emission tomography (PET) in estimating coronary artery disease (CAD) mortality.

methodsThis subset analysis from the PET Prognosis Multicenter Registry includes a total of 2,398 patients undergoing rest/stress Rb-PET from three participating sites. The HRR from rest to peak stress was categorized into tertiles of ≤ 4, 5-14, and ≥ 15 beats per minute (bpm). At stress, the % abnormal myocardium was categorized as <5%, 5-9.9%, and ≥ 10%. We estimated CAD mortality using univariable and multivariable Cox proportional hazard models.

resultsCAD mortality was 12.8%, 3.4%, and 0.8%, respectively, for HRR measurements of ≤ 4, 5-14, and ≥ 15 bpm (P < 0.0001). In a multivariable model, the HRR was independently predictive of CAD mortality (P < 0.0001) with adjusted hazard ratios elevated 3.5- and 8.4-fold for HRR of 5-14 and ≤ 4 versus ≥ 15 bpm. In a multivariable model, both the HRR and stress MPI % abnormal myocardium were independently and highly predictive of CAD mortality. Moreover, the net reclassification improvement was 0.18 for the HRR when compared to a model including risk factors, symptoms, rest HR, and PET variables (P = 0.0008). For those with ≥ 10% abnormal myocardium on stress PET, there was a graded relationship between HRR and CAD mortality with adjusted hazards exceeding 50-fold for measurements of 5-14 and ≤ 4 bpm (P < 0.0001) compared to stress MPI with <5% abnormal myocardium and a HRR ≥ 15 bpm.

conclusionA diminished HRR to vasodilator stress is a novel but increasingly important predictor of CAD mortality. HRR measurements of ≤ 4, 5-14, and ≥ 15 bpm were independently predictive of CAD mortality and underscore the importance of optimizing readily available novel markers of risk as highly relevant to identifying high and low risk patient subsets.

Indexed as

RegistriesRubidium RadioisotopesVasodilator AgentsAdultAgedAged, 80 and overCoronary Artery DiseaseExercise TestFemaleHeart RateHumansMaleMiddle AgedPositron-Emission TomographyPrevalencePrognosisRadiopharmaceuticalsRubidium RadioisotopesVasodilator Agents

Identifiers

PMID24482141

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.