Author + information
- Todd Rosenthal,
- Daniel Masvidal,
- Freddy Abi-Samra,
- Michael Bernard,
- Sammy Khatib,
- Glenn Polin,
- Paul Rogers,
- Robert Bober and
- Daniel Morin
Background: Our ability to predict life-threatening ventricular tachyarrhythmias (VT/VF) remains unsatisfactory. The predictive ability of myocardial flow capacity (FC) as assessed by cardiac positron emission tomography (PET) is unknown.
Methods: We enrolled sequential patients with an implantable cardioverter defibrillator (ICD) who underwent cardiac PET stress imaging. Absolute myocardial flow was quantified in mL/min/g. Reduced FC in the “definite ischemic zone” was defined as both stress myocardial blood flow <0.91 mL/min/g and coronary flow reserve <1.74. Patients were prospectively followed for VT/VF via periodic device interrogation. Patients were stratified by tertiles of percent myocardium with severely reduced flow capacity, and outcomes were assessed with the log-rank test.
Results: There were 120 patients (67±12 y, 78% M, LVEF 31±13%, 76% with macroscopic CAD) who met inclusion criteria. Over 32±19 months, there were 41 VT/VF events. Increased percentage of myocardium with severely reduced FC predicted VT/VF (HR per 5% increase: 1.06, CI 1.01-1.12, p=0.02). As shown in the Figure, patients in the lowest tertile (<4.4% of myocardium with reduced FC) had fewer events than those in the highest tertile (>32.1%), p=0.03.
Conclusions: Reduced myocardial flow capacity as measured by cardiac PET imaging predicts VT/VF in patients with an ICD.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Nuclear Cardiology: Coronary Flow
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1288-197
- 2017 American College of Cardiology Foundation