Atsushi Yamamoto, Michinobu Nagao, Masateru Kawakubo, Risako Nakao, Yuka Matsuo, Akiko Sakai, Koichiro Kaneko, Kenji Fukushima, Mitsuru Momose, Shuji Sakai, Junichi Yamaguchi
{"title":"利用 13N-Ammonia PET 得出的缺血性心脏病患者右心室纵向应变比进行风险分层","authors":"Atsushi Yamamoto, Michinobu Nagao, Masateru Kawakubo, Risako Nakao, Yuka Matsuo, Akiko Sakai, Koichiro Kaneko, Kenji Fukushima, Mitsuru Momose, Shuji Sakai, Junichi Yamaguchi","doi":"10.1148/ryct.230298","DOIUrl":null,"url":null,"abstract":"<p><p>Purpose To investigate whether right ventricular (RV) myocardial strain ratio (RVMSR) assessed using nitrogen 13 ammonia (<sup>13</sup>N-NH<sub>3</sub>) PET can predict cardiovascular events in patients with ischemic heart disease (IHD). Materials and Methods This retrospective study included 480 consecutive patients (mean age, 66 years ± 12 [SD]; 334 males and 146 females) with IHD who underwent <sup>13</sup>N-NH<sub>3</sub> PET. RVMSR was defined as the ratio of RV strain during stress to that at rest. The primary end point was major adverse cardiac events (MACEs), defined as cardiac death or heart failure hospitalization. The ability of RVMSR to predict MACE was assessed using receiver operating characteristic (ROC) curve and Kaplan-Meier analyses. Cox proportional hazards regression analysis was used to calculate hazard ratios (HRs) with 95% CIs. Results ROC curve analysis identified a sensitivity and specificity of 84% and 82%, respectively, for predicting MACE from RVMSR. Patients with reduced RVMSR (<110.2) displayed a significantly higher rate of MACE than those with a preserved RVMSR (34 of 240 vs four of 240; <i>P</i> < .001). Cox proportional hazards regression analysis of imaging parameters, including myocardial flow reserve, indicated that RVMSR was an independent predictor of MACE (HR, 0.94 [95% CI: 0.92, 0.97]; <i>P</i> < .001). Conclusion RVMSR was an independent predictor of MACE and has potential to aid in the risk stratification of patients with IHD. <b>Keywords:</b> Right Ventricular Myocardial Strain Ratio, Myocardial Flow Reserve, Ischemic Heart Disease, <sup>13</sup>N-Ammonia Positron Emission Tomography <i>Supplemental material is available for this article.</i> © RSNA, 2024.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11211937/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk Stratification Using Right Ventricular Longitudinal Strain Ratio Derived from <sup>13</sup>N-Ammonia PET in Patients with Ischemic Heart Disease.\",\"authors\":\"Atsushi Yamamoto, Michinobu Nagao, Masateru Kawakubo, Risako Nakao, Yuka Matsuo, Akiko Sakai, Koichiro Kaneko, Kenji Fukushima, Mitsuru Momose, Shuji Sakai, Junichi Yamaguchi\",\"doi\":\"10.1148/ryct.230298\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Purpose To investigate whether right ventricular (RV) myocardial strain ratio (RVMSR) assessed using nitrogen 13 ammonia (<sup>13</sup>N-NH<sub>3</sub>) PET can predict cardiovascular events in patients with ischemic heart disease (IHD). Materials and Methods This retrospective study included 480 consecutive patients (mean age, 66 years ± 12 [SD]; 334 males and 146 females) with IHD who underwent <sup>13</sup>N-NH<sub>3</sub> PET. RVMSR was defined as the ratio of RV strain during stress to that at rest. The primary end point was major adverse cardiac events (MACEs), defined as cardiac death or heart failure hospitalization. The ability of RVMSR to predict MACE was assessed using receiver operating characteristic (ROC) curve and Kaplan-Meier analyses. Cox proportional hazards regression analysis was used to calculate hazard ratios (HRs) with 95% CIs. Results ROC curve analysis identified a sensitivity and specificity of 84% and 82%, respectively, for predicting MACE from RVMSR. Patients with reduced RVMSR (<110.2) displayed a significantly higher rate of MACE than those with a preserved RVMSR (34 of 240 vs four of 240; <i>P</i> < .001). Cox proportional hazards regression analysis of imaging parameters, including myocardial flow reserve, indicated that RVMSR was an independent predictor of MACE (HR, 0.94 [95% CI: 0.92, 0.97]; <i>P</i> < .001). Conclusion RVMSR was an independent predictor of MACE and has potential to aid in the risk stratification of patients with IHD. <b>Keywords:</b> Right Ventricular Myocardial Strain Ratio, Myocardial Flow Reserve, Ischemic Heart Disease, <sup>13</sup>N-Ammonia Positron Emission Tomography <i>Supplemental material is available for this article.</i> © RSNA, 2024.</p>\",\"PeriodicalId\":21168,\"journal\":{\"name\":\"Radiology. Cardiothoracic imaging\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11211937/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiology. Cardiothoracic imaging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1148/ryct.230298\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology. Cardiothoracic imaging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1148/ryct.230298","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
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