Author + information
- Maulik Majmudar,
- Venkatesh Murthy,
- Swathy Kolli,
- Negareh Mousavi,
- Masanao Naya,
- Courtney Foster,
- Jon Hainer,
- Arkadiusz Sitek,
- Ron Blankstein,
- Sharmila Dorbala,
- Mandeep Mehra and
- Marcelo F. Di Carli
Although abnormal coronary vascular function is frequently seen in LV systolic dysfunction, little is known about its association with clinical outcomes.
510 consecutive patients with ischemic (ICM) and non-ischemic (NICM) cardiomyopathy with rest LVEF ≤45% underwent myocardial perfusion PET imaging to quantify coronary flow reserve (CFR, stress/rest myocardial blood flow). The primary end-point was a composite of major adverse cardiovascular events (MACE) including cardiac death, heart failure hospitalization, late revascularization, and aborted sudden cardiac death. Median follow-up was 15.6 months. Cox proportional hazards model was used to adjust for clinical variables.
The annualized MACE rate was 26.9%. Patients in the lowest two tertiles of CFR (CFR ≤1.65) experienced higher MACE rates than those in the highest tertile (34.2% vs 16.0% per year, respectively, p<0.001), irrespective of etiology of cardiomyopathy. In ischemic cardiomyopathy (ICM), CFR ≤1.65 was significantly associated with cardiac death; whereas, in non-ischemic cardiomyopathy (NICM), CFR >1.65 was independently associated with reduced heart failure hospitalizations (Figure 1).
In patients with systolic dysfunction, the severity of coronary vascular dysfunction on PET is associated with major adverse cardiovascular events. Furthermore, moderate-to-severely impaired CFR is associated with distinct cardiovascular outcomes based on etiology of cardiomyopathy.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Cardiac PET: Towards Flow Quantification and Novel Applications
Abstract Category: 21. Imaging: Nuclear
Presentation Number: 1139-324
- 2013 American College of Cardiology Foundation