ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2014
Stress positron emission tomography is safe and can guide coronary revascularization in high-risk patients being considered for transcatheter aortic valve replacement.
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 11 papers.
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Who cites it
11 citing papers in PubMed.
- Unravelling the Fate of Coronary Artery Disease in Patients Undergoing Valve Replacement for Severe Aortic Valve Stenosis.Reviews in cardiovascular medicine · 2023Review
- Challenges in Diagnosis and Functional Assessment of Coronary Artery Disease in Patients With Severe Aortic Stenosis.Frontiers in cardiovascular medicine · 2022Review
- Coronary Assessment and Revascularization Before Transcutaneous Aortic Valve Implantation: An Update on Current Knowledge.Frontiers in cardiovascular medicine · 2021Review
- Coronary Microcirculation in Aortic Stenosis: Pathophysiology, Invasive Assessment, and Future Directions.Journal of interventional cardiology · 2020Review
- The clinical value and safety of ECG-gated dipyridamole myocardial perfusion imaging in patients with aortic stenosis.Scientific reports · 2019Article
- Pathophysiological coronary and microcirculatory flow alterations in aortic stenosis.Nature reviews. Cardiology · 2018Review
- The use of vasodilator myocardial perfusion imaging in severe aortic stenosis: Is it time for a new prospective study?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- An assessment of the safety, hemodynamic response, and diagnostic accuracy of commonly used vasodilator stressors in patients with severe aortic stenosis.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Article
- Assessment, treatment, and prognostic implications of CAD in patients undergoing TAVI.Nature reviews. Cardiology · 2016Review
- Review of cardiovascular imaging in The Journal of Nuclear Cardiology in 2014: Part 1 of 2: Positron emission tomography, computed tomography, and neuronal imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe safety and accuracy of regadenoson stress positron emission tomography (PET) in patients with significant aortic stenosis (AS) is unknown. In patients undergoing surgical aortic valve replacement, coronary artery bypass grafting for coronary artery disease is standard, but the appropriate revascularization strategy in patients undergoing TAVR is uncertain. Stress PET may identify patients that benefit from revascularization.
methodsFifty consecutive patients who were referred for consideration of TAVR and underwent a stress PET study were retrospectively identified. We assessed major adverse cardiac events and significant decreases in systolic blood pressure. The percentage of jeopardized myocardium was determined by combining ischemic and hibernating myocardium.
resultsOur patients were high risk with a mean Society of Thoracic Surgeons mortality score of 11.4% and had severe AS with a moderately reduced left ventricular ejection fraction (EF) (mean aortic valve area of 0.78 ± 0.25 cm(2) and mean EF of 39 ± 16%). There were no major adverse events during testing. Transient hypotension occurred in 16% of the patients. Revascularization was performed in 44% of patients, and 91% of these patients had revascularization to territories jeopardized on PET. These patients had substantial jeopardized myocardium (median 19%), and only 3 patients underwent revascularization despite less than 10% jeopardized myocardium.
conclusionsStress cardiac PET with regadenoson can be performed safely in patients with severe AS. Results of the PET study can accurately direct subsequent revascularization.
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