Prognostic value of myocardial flow reserve obtained by 82-rubidium positron emission tomography in long-term follow-up after heart transplantation

Lærke Marie Nelson; Thomas Emil Christensen; Kasper Rossing; Philip Hasbak; Finn Gustafsson

doi:10.1007/s12350-021-02742-3

Prognostic value of myocardial flow reserve obtained by 82-rubidium positron emission tomography in long-term follow-up after heart transplantation

Lærke Marie Nelson^*, Thomas Emil Christensen, Kasper Rossing, Philip Hasbak, Finn Gustafsson

^*Corresponding author for this work

2 Citations (Scopus)

Abstract

BACKGROUND: Cardiac allograft vasculopathy (CAV) is a leading cause of death following heart transplantation (HTx) and non-invasive prognostic methods in long-term CAV surveillance are needed. We evaluated the prognostic value of myocardial flow reserve (MFR) obtained by 82-rubidium (<sup>82</sup>Rb) positron emission tomography (PET).

METHODS: Recipients undergoing dynamic rest-stress <sup>82</sup>Rb PET between April 2013 and June 2017 were retrospectively evaluated in a single-center study. Evaluation by PET included quantitative myocardial blood flow and semiquantitative myocardial perfusion imaging. Patients were grouped by MFR (MFR ≤ 2.0 vs MFR > 2.0) and the primary outcome was all-cause mortality.

RESULTS: A total of 50 patients (68% men, median age 57 [IQR: 43 to 68]) were included. Median time from HTx to PET was 10.0 (6.7 to 16.0) years. In 58% of patients CAV was documented prior to PET. During a median follow-up of 3.6 (2.3 to 4.3) years 12 events occurred. Survival probability by Kaplan-Meier method was significantly higher in the high-MFR group (log-rank P = .02). Revascularization (n = 1), new CAV diagnosis (n = 1), and graft failure (n = 4) were more frequent in low-MFR patients. No retransplantation occurred.

CONCLUSIONS: Myocardial flow reserve appears to offer prognostic value in selected long-term HTx recipients and holds promise as a non-invasive method for CAV surveillance possibly guiding management strategy.

Original language	English
Journal	Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
Volume	29
Issue number	5
Pages (from-to)	2555-2567
Number of pages	13
ISSN	1071-3581
DOIs	https://doi.org/10.1007/s12350-021-02742-3
Publication status	Published - Oct 2022

Keywords

Coronary Artery Disease/diagnostic imaging
Female
Follow-Up Studies
Heart Transplantation/adverse effects
Humans
Male
Middle Aged
Myocardial Perfusion Imaging/methods
Positron-Emission Tomography/methods
Prognosis
Retrospective Studies
Rubidium
Rubidium Radioisotopes

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10.1007/s12350-021-02742-3

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Nelson, L. M., Christensen, T. E., Rossing, K., Hasbak, P., & Gustafsson, F. (2022). Prognostic value of myocardial flow reserve obtained by 82-rubidium positron emission tomography in long-term follow-up after heart transplantation. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 29(5), 2555-2567. https://doi.org/10.1007/s12350-021-02742-3

Prognostic value of myocardial flow reserve obtained by 82-rubidium positron emission tomography in long-term follow-up after heart transplantation. / Nelson, Lærke Marie; Christensen, Thomas Emil; Rossing, Kasper et al.
In: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, Vol. 29, No. 5, 10.2022, p. 2555-2567.

Research output: Contribution to journal › Journal article › Research › peer-review

Nelson, LM, Christensen, TE, Rossing, K , Hasbak, P & Gustafsson, F 2022, 'Prognostic value of myocardial flow reserve obtained by 82-rubidium positron emission tomography in long-term follow-up after heart transplantation', Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, vol. 29, no. 5, pp. 2555-2567. https://doi.org/10.1007/s12350-021-02742-3

@article{997099c63d7e4deea56ed5fa731b2f25,

title = "Prognostic value of myocardial flow reserve obtained by 82-rubidium positron emission tomography in long-term follow-up after heart transplantation",

abstract = "BACKGROUND: Cardiac allograft vasculopathy (CAV) is a leading cause of death following heart transplantation (HTx) and non-invasive prognostic methods in long-term CAV surveillance are needed. We evaluated the prognostic value of myocardial flow reserve (MFR) obtained by 82-rubidium (82Rb) positron emission tomography (PET).METHODS: Recipients undergoing dynamic rest-stress 82Rb PET between April 2013 and June 2017 were retrospectively evaluated in a single-center study. Evaluation by PET included quantitative myocardial blood flow and semiquantitative myocardial perfusion imaging. Patients were grouped by MFR (MFR ≤ 2.0 vs MFR > 2.0) and the primary outcome was all-cause mortality.RESULTS: A total of 50 patients (68% men, median age 57 [IQR: 43 to 68]) were included. Median time from HTx to PET was 10.0 (6.7 to 16.0) years. In 58% of patients CAV was documented prior to PET. During a median follow-up of 3.6 (2.3 to 4.3) years 12 events occurred. Survival probability by Kaplan-Meier method was significantly higher in the high-MFR group (log-rank P = .02). Revascularization (n = 1), new CAV diagnosis (n = 1), and graft failure (n = 4) were more frequent in low-MFR patients. No retransplantation occurred.CONCLUSIONS: Myocardial flow reserve appears to offer prognostic value in selected long-term HTx recipients and holds promise as a non-invasive method for CAV surveillance possibly guiding management strategy.",

keywords = "Coronary Artery Disease/diagnostic imaging, Female, Follow-Up Studies, Heart Transplantation/adverse effects, Humans, Male, Middle Aged, Myocardial Perfusion Imaging/methods, Positron-Emission Tomography/methods, Prognosis, Retrospective Studies, Rubidium, Rubidium Radioisotopes",

author = "Nelson, {L{\ae}rke Marie} and Christensen, {Thomas Emil} and Kasper Rossing and Philip Hasbak and Finn Gustafsson",

note = "{\textcopyright} 2021. American Society of Nuclear Cardiology.",

year = "2022",

month = oct,

doi = "10.1007/s12350-021-02742-3",

language = "English",

volume = "29",

pages = "2555--2567",

journal = "Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology",

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TY - JOUR

T1 - Prognostic value of myocardial flow reserve obtained by 82-rubidium positron emission tomography in long-term follow-up after heart transplantation

AU - Nelson, Lærke Marie

AU - Christensen, Thomas Emil

AU - Rossing, Kasper

AU - Hasbak, Philip

AU - Gustafsson, Finn

PY - 2022/10

Y1 - 2022/10

N2 - BACKGROUND: Cardiac allograft vasculopathy (CAV) is a leading cause of death following heart transplantation (HTx) and non-invasive prognostic methods in long-term CAV surveillance are needed. We evaluated the prognostic value of myocardial flow reserve (MFR) obtained by 82-rubidium (82Rb) positron emission tomography (PET).METHODS: Recipients undergoing dynamic rest-stress 82Rb PET between April 2013 and June 2017 were retrospectively evaluated in a single-center study. Evaluation by PET included quantitative myocardial blood flow and semiquantitative myocardial perfusion imaging. Patients were grouped by MFR (MFR ≤ 2.0 vs MFR > 2.0) and the primary outcome was all-cause mortality.RESULTS: A total of 50 patients (68% men, median age 57 [IQR: 43 to 68]) were included. Median time from HTx to PET was 10.0 (6.7 to 16.0) years. In 58% of patients CAV was documented prior to PET. During a median follow-up of 3.6 (2.3 to 4.3) years 12 events occurred. Survival probability by Kaplan-Meier method was significantly higher in the high-MFR group (log-rank P = .02). Revascularization (n = 1), new CAV diagnosis (n = 1), and graft failure (n = 4) were more frequent in low-MFR patients. No retransplantation occurred.CONCLUSIONS: Myocardial flow reserve appears to offer prognostic value in selected long-term HTx recipients and holds promise as a non-invasive method for CAV surveillance possibly guiding management strategy.

AB - BACKGROUND: Cardiac allograft vasculopathy (CAV) is a leading cause of death following heart transplantation (HTx) and non-invasive prognostic methods in long-term CAV surveillance are needed. We evaluated the prognostic value of myocardial flow reserve (MFR) obtained by 82-rubidium (82Rb) positron emission tomography (PET).METHODS: Recipients undergoing dynamic rest-stress 82Rb PET between April 2013 and June 2017 were retrospectively evaluated in a single-center study. Evaluation by PET included quantitative myocardial blood flow and semiquantitative myocardial perfusion imaging. Patients were grouped by MFR (MFR ≤ 2.0 vs MFR > 2.0) and the primary outcome was all-cause mortality.RESULTS: A total of 50 patients (68% men, median age 57 [IQR: 43 to 68]) were included. Median time from HTx to PET was 10.0 (6.7 to 16.0) years. In 58% of patients CAV was documented prior to PET. During a median follow-up of 3.6 (2.3 to 4.3) years 12 events occurred. Survival probability by Kaplan-Meier method was significantly higher in the high-MFR group (log-rank P = .02). Revascularization (n = 1), new CAV diagnosis (n = 1), and graft failure (n = 4) were more frequent in low-MFR patients. No retransplantation occurred.CONCLUSIONS: Myocardial flow reserve appears to offer prognostic value in selected long-term HTx recipients and holds promise as a non-invasive method for CAV surveillance possibly guiding management strategy.

KW - Coronary Artery Disease/diagnostic imaging

KW - Female

KW - Follow-Up Studies

KW - Heart Transplantation/adverse effects

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Perfusion Imaging/methods

KW - Positron-Emission Tomography/methods

KW - Prognosis

KW - Retrospective Studies

KW - Rubidium

KW - Rubidium Radioisotopes

UR - http://www.scopus.com/inward/record.url?scp=85113160284&partnerID=8YFLogxK

U2 - 10.1007/s12350-021-02742-3

DO - 10.1007/s12350-021-02742-3

M3 - Journal article

C2 - 34414554

SN - 1071-3581

VL - 29

SP - 2555

EP - 2567

JO - Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

JF - Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

IS - 5

ER -

Prognostic value of myocardial flow reserve obtained by 82-rubidium positron emission tomography in long-term follow-up after heart transplantation

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