Evidence map›Paper›PMID 29177706›Full record

Observational studyEuropean journal of nuclear medicine and molecular imaging2018

Prognostic value of vasodilator response using rubidium-82 positron emission tomography myocardial perfusion imaging in patients with coronary artery disease.

Punitha Arasaratnam, Masoud Sadreddini, Yeung Yam, Vinay Kansal, Sharmila Dorbala, Marcelo F Di Carli, Rob S Beanlands, Michael E Merhige, Brent A Williams, Emir Veledar and 7 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in European journal of nuclear medicine and molecular imaging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. How to assess nonresponsiveness to vasodilator stress.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2024
    Review
  2. Exponential dosing to standardize myocardial perfusion image quality with rubidium-82 PET.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023
    Article
  3. Long-Term Prognostic Value ofJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2023
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Punitha ArasaratnamCanada, Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
Masoud SadreddiniCanada, Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
Yeung YamCanada, Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
Vinay KansalCanada, Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
Sharmila DorbalaDivision of Cardiovascular Medicine and Division of Nuclear Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Marcelo F Di CarliDivision of Cardiovascular Medicine and Division of Nuclear Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Rob S BeanlandsCanada, Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
Michael E MerhigeDepartments of Cardiology, Internal Medicine, and Nuclear Medicine, Niagara Falls Memorial Medical Center, Buffalo, NY, USA.
Brent A WilliamsDepartment of Center for Health Research, Geisinger Medical Center, Danville, PA, USA.
Emir VeledarDepartment of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
James K MinDepartment of Radiology and Department of Imaging, Weill Cornell Medical College, New York, NY, USA.
Li ChenCardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Terrence D RuddyCanada, Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
Guido GermanoDepartment of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Daniel S BermanDepartment of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Leslee J ShawDepartment of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Benjamin J W ChowCanada, Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada. bchow@ottawaheart.ca.

Funding

Prognostic Utility of Absolute Coronary Microvascular Function by PET/CTK23HL092299 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI DORBALA, SHARMILA · 2009 to 2013
$705k
Heart and Stroke Foundation of Ontario PRG6242National Heart, Lung, and Blood Institute grant K23HL092299
6 · The paper itself

Abstract

backgroundPrognostic value of positron emission tomography (PET) myocardial perfusion imaging (MPI) is well established. There is paucity of data on how the prognostic value of PET relates to the hemodynamic response to vasodilator stress. We hypothesize that inadequate hemodynamic response will affect the prognostic value of PET MPI. METHODS AND

resultsUsing a multicenter rubidium (Rb)-82 PET registry, 3406 patients who underwent a clinically indicated rest/stress PET MPI with a vasodilator agent were analyzed. Patients were categorized as, "responders" [increase in heart rate ≥ 10 beats per minute (bpm) and decrease in systolic blood pressure (SBP) ≥10 mmHg], "partial responders" (either a change in HR or SBP), and "non-responders" (no change in HR or SBP). Primary outcome was all-cause death (ACD), and secondary outcome was cardiac death (CD). Ischemic burden was measured using summed stress score (SSS) and % left ventricular (LV) ischemia. After a median follow-up of 1.68 years (interquartile range = 1.17- 2.55), there were 7.9% (n = 270) ACD and 2.6% (n = 54) CD. Responders with a normal PET MPI had an annualized event rate (AER) of 1.22% (SSS of 0-3) and 1.58% (% LV ischemia = 0). Partial and non-responders had higher AER with worsening levels of ischemic burden. In the presence of severe SSS ≥12 and LV ischemia of ≥10%, partial responders had an AER of 10.79% and 10.36%, compared to non-responders with an AER of 19.4% and 12.43%, respectively. Patient classification was improved when SSS was added to a model containing clinical variables (NRI: 42%, p < 0.001) and responder category was added (NRI: 61%, p < 0.001). The model including clinical variables, SSS and hemodynamic response has good discrimination ability (Harrell C statistics: 0.77 [0.74-0.80]).

conclusionHemodynamic response during a vasodilator Rb-82 PET MPI is predictive of ACD. Partial and non-responders may require additional risk stratification leading to altered patient management.

Indexed as

Myocardial Perfusion ImagingPositron-Emission TomographyRubidium RadioisotopesAgedCoronary Artery DiseaseExercise TestFemaleHumansMaleMiddle AgedPercutaneous Coronary InterventionPrognosisVasodilator AgentsRubidium-82Rubidium RadioisotopesVasodilator AgentsAll- cause deathBlood pressureHeart ratePositron emission tomographyPrognosis

Identifiers

PMID29177706

What OpenQuestion holds

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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.