ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2021
Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 23 citations in OpenAlex.
- Diagnosis of multivessel coronary artery disease usingJapanese journal of radiology · 2026Article
- Myocardial blood flow reference values for 13N-ammonia PET myocardial perfusion imaging in patients without flow-limiting coronary artery disease.European journal of nuclear medicine and molecular imaging · 2025Article
- Clinical significance of splenic switch-off in adenosine triphosphateJapanese journal of radiology · 2025Article
- How to assess nonresponsiveness to vasodilator stress.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2024Review
- Adenosine-induced splenic switch-off on [EJNMMI research · 2023Article
- Extracardiac findings with increased perfusion during clinical O-15-HJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- The Role of Cardiac PET in Diagnosis and Prognosis of Ischemic Heart Disease: Optimal Modality Across Different Patient Populations.Current atherosclerosis reports · 2023Review
- Assessing splenic switch-off in Adenosine stress CMR for patients with atrial fibrillation: a propensity-matched study.The British journal of radiology · 2022Article
- Spleen Perfusion as an Index of Gender Impact on Sympathetic Nervous System Response to Exercise.Frontiers in physiology · 2021Article
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInadequate coronary adenosine response is a potential cause for false negative ischemia testing. Recently, the splenic switch-off (SSO) sign has been identified as a promising tool to ascertain the efficacy of adenosine during vasodilator stress cardiovascular magnetic resonance imaging (CMR). We assessed the value of SSO to predict adenosine response, defined as an increase in myocardial blood flow (MBF) during quantitative stress myocardial perfusion 13 N-ammonia positron emission tomography (PET).
methodsWe prospectively enrolled 64 patients who underwent simultaneous CMR and PET myocardial perfusion imaging on a hybrid PET/CMR scanner with co-injection of gadolinium based contrast agent (GBCA) and 13N-ammonia during rest and adenosine-induced stress. A myocardial flow reserve (MFR) of > 1.5 or ischemia as assessed by PET were defined as markers for adequate coronary adenosine response. The presence or absence of SSO was visually assessed. The stress-to-rest intensity ratio (SIR) was calculated as the ratio of stress over rest peak signal intensity for splenic tissue. Additionally, the spleen-to-myocardium ratio, defined as the relative change of spleen to myocardial signal, was calculated for stress (SMR
resultsSixty-one (95%) patients were coronary adenosine responders, but SSO was absent in 18 (28%) patients. SIR and SMR
conclusionsThe presence of SSO implies adequate coronary adenosine-induced MBF response. Its absence, however, is not a reliable indicator for failed adenosine-induced coronary vasodilatation.
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