Kutaiba Nazif, A Sami Abuzaid, Stephen Horgan, Krishna K Patel, Matthieu Pelletier-Galarneau, Tamara Naneishvili, Gary Heller, Parthiban Arumugam
{"title":"Role of rubidium-82 positron emission tomography in a multimodality approach to diagnosing coronary microvascular dysfunction in apical hypertrophic cardiomyopathy.","authors":"Kutaiba Nazif, A Sami Abuzaid, Stephen Horgan, Krishna K Patel, Matthieu Pelletier-Galarneau, Tamara Naneishvili, Gary Heller, Parthiban Arumugam","doi":"10.1016/j.nuclcard.2025.102197","DOIUrl":"10.1016/j.nuclcard.2025.102197","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102197"},"PeriodicalIF":3.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ilias Nikolakopoulos, Ibolya Csecs, Yi-Hwa Liu, Albert J Sinusas, Edward J Miller, Attila Feher
{"title":"Temporal changes in PET myocardial flow reserve: Implications for cardiovascular outcomes.","authors":"Ilias Nikolakopoulos, Ibolya Csecs, Yi-Hwa Liu, Albert J Sinusas, Edward J Miller, Attila Feher","doi":"10.1016/j.nuclcard.2025.102194","DOIUrl":"10.1016/j.nuclcard.2025.102194","url":null,"abstract":"<p><strong>Background: </strong>The usefulness of serial measurements of myocardial flow reserve (MFR) has received limited study outside of transplant vasculopathy. We describe the trends of myocardial blood flow and perfusion over time in patients undergoing positron emission tomography (PET) myocardial perfusion imaging (MPI) for the evaluation of coronary artery disease, and their association with cardiovascular outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 474 patients without a history of heart transplant who underwent serial PET MPI (N = 948 studies) for the evaluation of coronary artery disease at Yale New Haven Hospital between 2016 and 2022. Patients were categorized according to MFR trajectory (low to low, low to high, high to low, high to high). Long-term major adverse cardiovascular events (MACE), defined as death or myocardial infarction, were analyzed with the Kaplan-Meier method and Cox regression. Log-likelihood, C-statistic and net reclassification were used to assess model performance.</p><p><strong>Results: </strong>The median interval time between tests was 776 days (IQR: 497-1058). The most common indications for the first and second PET were chest pain and dyspnea. MFR was similar in serial exams (2.1 [1.7, 2.6] vs 2.1 [1.7, 2.5], P = .75), but rest (1 [.8, 1.3] vs .9 [.7, 1] P < .01) and stress flows (2.1 [1.6, 2.8] vs 1.8 [1.4, 2.2], P < .01) were both reduced on the second PET. MFR increased in patients with revascularization between tests (N = 62 patients) (1.6 [1.3, 2.0] vs 1.7 [1.2, 2.2], P = .04). During a median follow-up time of 17 [8,28] months, the rate of MACE was 12% (51 events) and was higher in the low-to-low and low-to-high categories in multivariable analysis. The model including serial MFR and perfusion performed better than the baseline model including traditional clinical risk factors in terms of the likelihood ratio and C-statistic (from .74 to .80, P = .04).</p><p><strong>Conclusions: </strong>In conclusion, our findings suggest that the serial assessment of MFR and perfusion may improve risk stratification beyond traditional clinical risk factors.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102194"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert Jh Miller, Aakash Shanbhag, Anna M Marcinkiewicz, Helen Struble, Heidi Gransar, Waseem Hijazi, Hidesato Fujito, Evan Kransdorf, Paul Kavanagh, Joanna X Liang, Valerie Builoff, Damini Dey, Daniel S Berman, Piotr J Slomka
{"title":"AI-enabled CT-guided end-to-end quantification of total cardiac activity in 18FDG cardiac PET/CT for detection of cardiac sarcoidosis.","authors":"Robert Jh Miller, Aakash Shanbhag, Anna M Marcinkiewicz, Helen Struble, Heidi Gransar, Waseem Hijazi, Hidesato Fujito, Evan Kransdorf, Paul Kavanagh, Joanna X Liang, Valerie Builoff, Damini Dey, Daniel S Berman, Piotr J Slomka","doi":"10.1016/j.nuclcard.2025.102195","DOIUrl":"10.1016/j.nuclcard.2025.102195","url":null,"abstract":"<p><strong>Background: </strong>[18F]-fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) plays a central role in diagnosing and managing cardiac sarcoidosis. We propose a fully automated pipeline for quantification of [18F]FDG PET activity using deep learning (DL) segmentation of cardiac chambers on computed tomography (CT) attenuation maps and evaluate quantitative approaches based on this framework.</p><p><strong>Methods: </strong>We included consecutive patients undergoing [18F]FDG PET/CT for suspected cardiac sarcoidosis. DL segmented left atrium, left ventricle (LV), right atrium, right ventricle, aorta, LV myocardium, and lungs from CT attenuation scans. CT-defined anatomical regions were applied to [18F]FDG PET images automatically to quantify target to background ratio (TBR), volume of inflammation (VOI) and cardiometabolic activity (CMA) using full sized and shrunk segmentations.</p><p><strong>Results: </strong>A total of 69 patients were included, with mean age of 56.1 ± 13.4 and cardiac sarcoidosis present in 29 (42 %). CMA had highest prediction performance (area under the receiver operating characteristic curve [AUC] .919, 95 % confidence interval [CI] .858 - .980) followed by VOI (AUC .903, 95 % CI .834 - .971), TBR (AUC .891, 95 % CI .819 - .964), and maximum standardized uptake value (AUC .812, 95 % CI .701 - .923). Abnormal CMA (≥1) had a sensitivity of 100 % and specificity 65 % for cardiac sarcoidosis. Lung quantification was able to identify patients with pulmonary abnormalities.</p><p><strong>Conclusion: </strong>We demonstrate that fully automated volumetric quantification of [18F]FDG PET for cardiac sarcoidosis based on CT attenuation map-derived volumetry is feasible, rapid, and has high prediction performance. This approach provides objective measurements of cardiac inflammation with consistent definition of myocardium and background region.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102195"},"PeriodicalIF":3.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahmoud Al Rifai, Maria Alwan, Ahmed Ibrahim Ahmed, Faisal Nabi, Ahmed Soliman, Jean Michel Saad, Sherif F Nagueh, Tariq Nabil, Khurram Nasir, Kershaw V Patel, John J Mahmarian, Mouaz H Al-Mallah
{"title":"The impact of obesity on myocardial flow reserve and its prognostic utility.","authors":"Mahmoud Al Rifai, Maria Alwan, Ahmed Ibrahim Ahmed, Faisal Nabi, Ahmed Soliman, Jean Michel Saad, Sherif F Nagueh, Tariq Nabil, Khurram Nasir, Kershaw V Patel, John J Mahmarian, Mouaz H Al-Mallah","doi":"10.1016/j.nuclcard.2025.102193","DOIUrl":"10.1016/j.nuclcard.2025.102193","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major cardiovascular risk factor associated with coronary microvascular dysfunction, which can be noninvasively assessed using myocardial flow reserve (MFR) on positron emission tomography (PET). As impaired MFR identifies high-risk patients, we assessed whether body mass index (BMI) modifies the association between MFR and cardiovascular outcomes.</p><p><strong>Methods: </strong>Consecutive patients with no known coronary artery disease who had a clinically indicated PET were enrolled and followed prospectively for incident outcomes (all-cause death, major adverse cardiovascular events (MACE), and heart failure admissions). Multivariable-adjusted Cox proportional hazards models were used to study the association between MFR, and incident events stratified by BMI categories.</p><p><strong>Results: </strong>The study population consisted of 3397 patients; median (IQR) age 67 (59-74) years, 55.2% female, 63.9% White, 17.6% with a BMI of 18.5-<25 kg/m<sup>2</sup>, 27.5% with a BMI of 25-<30 kg/m<sup>2</sup>, 38.6% with a BMI of 30-<40 kg/m<sup>2</sup>, and 16.3% with a BMI of ≥40 kg/m<sup>2</sup>. The median (IQR) MFR was 2.35 (1.96-2.80). Over a median (IQR) follow-up time of 1.34 (.43-2.43) years, there were 125 incident events (56 MACE, 6 HF admissions, and 70 deaths). In adjusted analyses, a .1-unit increase in MFR was significantly associated with decreased incident outcomes; HR (95% CI):0.91 (95% CI .84-.99) for BMI 18.5-<25 kg/m<sup>2</sup>, .88 (.83-.94) for BMI 25-<30 kg/m<sup>2</sup>, .93 (.87-.99) for BMI 30-<40 kg/m<sup>2</sup>, and .88 (.76-1.01) for BMI ≥40 kg/m<sup>2</sup>. There was no significant interaction between MFR and BMI; P = .381.</p><p><strong>Conclusion: </strong>PET-derived global MFR is inversely associated with subsequent cardiovascular outcomes in all BMI categories.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102193"},"PeriodicalIF":3.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiac sympathetic activity in patients suffering from heart failure with improved ejection fraction.","authors":"Yohei Ishibashi, Shu Kasama, Hideki Ishii","doi":"10.1016/j.nuclcard.2025.102196","DOIUrl":"10.1016/j.nuclcard.2025.102196","url":null,"abstract":"<p><strong>Background: </strong>The characteristics of cardiac sympathetic nerve activity among patients suffering from heart failure (HF) with improved ejection fraction (EF) (HFimpEF) remain unclear.</p><p><strong>Methods: </strong>Patients admitted for HF with an EF ≤ 40% who underwent echocardiography and <sup>123</sup>I-metaiodobenzylguanidine scintigraphy before and 6 months after discharge were followed for 5.2 (2.8-6.1) years. At 6 months, patients with an EF ≤ 40% were classified into the HF with reduced EF (HFrEF) group. Meanwhile, patients with an EF of >40% were classified under the HFimpEF group.</p><p><strong>Results: </strong>Among the 188 patients analyzed, 78 (41.5%) and 110 (58.5%) were categorized into the HFimpEF and HFrEF groups, respectively. The HFimpEF group had a better heart-to-mediastinal (H/M) ratio at baseline than did the HFrEF group (1.76 [1.59-1.85] vs 1.64 [1.48-1.81], respectively; P = .011). The predictive factors of HFimpEF included ischemic heart disease (odds ratio [OR]: .45, 95% confidence interval [CI]: .21-.94, P = .034), H/M ratio (OR: 1.02, 95% CI: 1.00-1.04, P = .032), and EF (OR: 1.14, 95% CI: 1.08-1.21, P < .001).</p><p><strong>Conclusions: </strong>The HFimpEF group had a higher H/M ratio than did the HFrEF group, suggesting lower cardiac sympathetic hyperactivity. The H/M ratio was identified as an independent predictor of HFimpEF.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102196"},"PeriodicalIF":3.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiac radionuclide imaging should play a more important role in China.","authors":"Wenkai Bi, Wei Teng, Qing Xia, Shuzhan Yao","doi":"10.1016/j.nuclcard.2025.102176","DOIUrl":"10.1016/j.nuclcard.2025.102176","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102176"},"PeriodicalIF":3.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The rise of quantitative positron emission tomography: Redefining the evaluation of coronary artery disease","authors":"Marcelo F. Di Carli MD, MASNC","doi":"10.1016/j.nuclcard.2025.102179","DOIUrl":"10.1016/j.nuclcard.2025.102179","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"45 ","pages":"Article 102179"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is it solid enough? Diagnostic performance of solid-state detector technology without attenuation CT against invasive angiography","authors":"Attila Feher MD, PhD , Mouaz H. Al-Mallah MD, MSc","doi":"10.1016/j.nuclcard.2025.102163","DOIUrl":"10.1016/j.nuclcard.2025.102163","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"45 ","pages":"Article 102163"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rami Doukky MD, MSc, MBA, FASNC , Jonathan Tottleben MD
{"title":"Taking large language models to the test: The challenge of training the next generation of nuclear cardiologists","authors":"Rami Doukky MD, MSc, MBA, FASNC , Jonathan Tottleben MD","doi":"10.1016/j.nuclcard.2025.102148","DOIUrl":"10.1016/j.nuclcard.2025.102148","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"45 ","pages":"Article 102148"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}