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Meeting ReportClinical Science

Prognostic significance of simultaneous analysis with global myocardial flow reserve and myocardial strain under vasodilator stress using cardiac PETMR

Ryo Yamakuni, Keiichiro Endo, Takatoyo Kiko, Shiro Ishii, Takayoshi Yamaki, Katsuyuki Kikori, Naoyuki Ukon, Hiroshi Ito, Kenji Fukushima and Yasuchika Takeishi
Journal of Nuclear Medicine June 2022, 63 (supplement 2) 2465;
Ryo Yamakuni
1Department of Radiology and Nuclear Medicine Fukushima Medical University
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Keiichiro Endo
2Dept of Cardiology, Fukushima Medical University, Fukushima, Japan.
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Takatoyo Kiko
2Dept of Cardiology, Fukushima Medical University, Fukushima, Japan.
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Shiro Ishii
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Takayoshi Yamaki
2Dept of Cardiology, Fukushima Medical University, Fukushima, Japan.
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Katsuyuki Kikori
3Dept of Radiological service, Fukushima Medical University, Fukushima, Japan.
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Naoyuki Ukon
4Advanced Clinical Research Center, Fukushima Global Medical Science Center, Fukushima Medical University
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Hiroshi Ito
4Advanced Clinical Research Center, Fukushima Global Medical Science Center, Fukushima Medical University
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Kenji Fukushima
5Dept of Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan.
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Yasuchika Takeishi
2Dept of Cardiology, Fukushima Medical University, Fukushima, Japan.
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Abstract

2465

Introduction: Measurement of global flow reserve is primal advantage for cardiac PET. Myocardial strain has emerged as a promising tool to detect subtle wall dysfunction. We aimed to evaluate the prognostic significance of combined analysis of myocardial flow reserve and strain using a dedicated PETMR system.

Methods: Fifty-nine patients (age 65±14, male 41) who underwent rest-stress ammonia PETMR were enrolled. Global myocardial flow reserve (MFR), cardiac function (left ventricular ejection fraction, LVEF), and summed stress score (SSS) were routinely generated. Global left ventricular longitudinal strain (GLS) was obtained from stress cine image using wall motion tracking technique (Medoviso Inc.). Major adverse cardiovascular event (MACE) was defined as the composite of cardiac death, myocardial infarction, late revascularization, unplanned hospitalization due to of worsening heart failure.

Results: GLS showed strong inverse correlation with stress LVEF, while its correlation was weak with MFR and SSS (r=-0.8, -0.26, and 0.3; p=0.001, 0.004, and 0.04, respectively). In follow up interval of 818±503 days, 18 events (cardiac death 3, late revascularization 15) occurred. Kaplan-Meier curve analysis showed that patients with MFR and GLS worse than the median value (1.79 and -13.7) had significantly higher rate of MACE (hazard ratio [HR], 95% confidence interval [95%CI]: HR 4.9, 95%CI 1.9-12.6, p=0.001; HR 3.2, 95%CI 1.2-8.7, p=0.026, respectively). After dividing into 4 groups above or below median MFR and GLS values, the group with low MFR and worse GLS showed the highest incidence of MACE (HR 5.3, 95%CI: 1.30-21.9, p=0.009).

Conclusions: Simultaneous analysis of global myocardial flow reserve and strain obtained from clinical PETMR may have incremental value for predicting adverse outcomes.

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Journal of Nuclear Medicine
Vol. 63, Issue supplement 2
June 1, 2022
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Prognostic significance of simultaneous analysis with global myocardial flow reserve and myocardial strain under vasodilator stress using cardiac PETMR
Ryo Yamakuni, Keiichiro Endo, Takatoyo Kiko, Shiro Ishii, Takayoshi Yamaki, Katsuyuki Kikori, Naoyuki Ukon, Hiroshi Ito, Kenji Fukushima, Yasuchika Takeishi
Journal of Nuclear Medicine Jun 2022, 63 (supplement 2) 2465;

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Prognostic significance of simultaneous analysis with global myocardial flow reserve and myocardial strain under vasodilator stress using cardiac PETMR
Ryo Yamakuni, Keiichiro Endo, Takatoyo Kiko, Shiro Ishii, Takayoshi Yamaki, Katsuyuki Kikori, Naoyuki Ukon, Hiroshi Ito, Kenji Fukushima, Yasuchika Takeishi
Journal of Nuclear Medicine Jun 2022, 63 (supplement 2) 2465;
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