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Early risk stratification using Rubidium-82 positron emission tomography in STEMI patients.


ABSTRACT:

Background

Assessment of infarct size after myocardial infarction is predictive of subsequent morphological changes and clinical outcome. This study aimed to assess subacute post-intervention Rubidium-82 (82Rb)-PET imaging in predicting left ventricle ejection fraction, regional wall motion, and final infarct size by CMR at 3-months after STEMI.

Methods

STEMI patients undergoing percutaneous coronary intervention were included prospectively. Rest-only 82Rb-PET perfusion imaging was performed at median 36 hours [IQR: 22 to 50] after the treatment. The extent of hypoperfusion and absolute blood flow (mL·min·g) were estimated on a global and a 17-segment model with dedicated software. At 3-months follow-up patients completed the CMR functional and late gadolinium enhancement imaging.

Results

42 patients were included, but only 35 had follow-up CMR and constituted the study population. Absolute blood flow was significantly lower in the infarct-related territory compared to remote myocardium, P < .005. Extent of hypoperfusion correlated with final infarct size, r = 0.58, P < .001, while blood flow correlated with ejection fraction, r = 0.41, P < .05. In linear mixed models, higher subacute absolute blood flow (? = 4.6, confidence interval [3.5; 5.2], P < .001, R2 = 0.67) was associated with greater wall motion. Segmental extent of subacute hypoperfusion (? = 0.43 [0.38; 0.49], P < .001, R2 = 0.58) was associated with the degree of late gadolinium enhancement at 3-months.

Conclusions

Subacute rest-only 82Rb-PET is feasible following STEMI and seems predictive of myocardial function and infarct size at 3-months.

SUBMITTER: Ghotbi AA 

PROVIDER: S-EPMC6430746 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Publications

Early risk stratification using Rubidium-82 positron emission tomography in STEMI patients.

Ghotbi Adam Ali AA   Hasbak Philip P   Nepper-Christensen Lars L   Lønborg Jacob J   Atharovski Kiril K   Christensen Thomas T   Holmvang Lene L   Engstrøm Thomas T   Ripa Rasmus Sejersten RS   Kjær Andreas A  

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 20170717 2


<h4>Background</h4>Assessment of infarct size after myocardial infarction is predictive of subsequent morphological changes and clinical outcome. This study aimed to assess subacute post-intervention Rubidium-82 (<sup>82</sup>Rb)-PET imaging in predicting left ventricle ejection fraction, regional wall motion, and final infarct size by CMR at 3-months after STEMI.<h4>Methods</h4>STEMI patients undergoing percutaneous coronary intervention were included prospectively. Rest-only <sup>82</sup>Rb-PE  ...[more]

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