1
|
Zhao Y, Hu Y, Li Y, Wang Y, Xiao Y, Xu L, Ren T, Wu Q, Wang R, Wu Z, Li S, Wu P. Spherization indices measured by resting SPECT improve risk stratification in patients with ischemia with non-obstructive coronary artery disease (INOCA). EJNMMI Res 2024; 14:16. [PMID: 38324108 PMCID: PMC10850039 DOI: 10.1186/s13550-024-01075-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/29/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The prevalence of ischemia with non-obstructive coronary artery disease (INOCA) is substantial, but its risk stratification has been suboptimal. Resting SPECT myocardial perfusion imaging (MPI) could provide useful heart information including spherical indices. We aimed to evaluate the prognostic value of spherical indices in individuals with INOCA. RESULTS During a median follow-up of 47.2 ± 20.8 months, 49 (17.2%) patients experienced major adverse cardiac events (MACE). Compared to those without MACE, those with MACE had a higher shape index (SI) (0.60 ± 0.07 vs. 0.58 ± 0.06; P = 0.028) and a lower E2 (eccentricity index calculated by the QPS) (0.81 ± 0.05 vs. 0.83 ± 0.04; P = 0.019). MACE event-free survival analysis revealed significant differences in the SI and E2 among all patients (all log-rank P < 0.01). Multivariate Cox analysis showed abnormal SI (HR: 2.73, 95% CI 1.44-5.18, P = 0.002) and E2 (HR: 1.94, 95% CI 1.08-3.48, P = 0.026) were both independent predictors for MACE when they were put into the same model, respectively. The incorporation of the SI into the baseline model demonstrated a significant improvement in the predictive accuracy for MACEs (P = 0.026), whereas E2 did not exhibit a similar improvement (P > 0.05). CONCLUSION For patients with INOCA, spherical indices (especially the SI) were associated with long-term MACE, which could be a preferable indicator for risk stratification and prognostic prediction.
Collapse
Affiliation(s)
- Yuting Zhao
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China
| | - Yingqi Hu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuanyuan Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yanhui Wang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuxin Xiao
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Li Xu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Tailin Ren
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Qiuyan Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ruonan Wang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zhifang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China.
| | - Ping Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China.
| |
Collapse
|
2
|
Aljizeeri A, Badarin FA, Al-Mallah MH. Automation in Nuclear Cardiology: Time for Flurpiridaz to Join the Club. J Nucl Cardiol 2022; 29:709-711. [PMID: 33205327 DOI: 10.1007/s12350-020-02421-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Ahmed Aljizeeri
- King Abdulaziz Cardiac Center, Riyadh, Kingdom of Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
| | | | - Mouaz H Al-Mallah
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA.
| |
Collapse
|
3
|
Yoda S, Hori Y, Hayase M, Mineki T, Hatta T, Suzuki Y, Matsumoto N, Hirayama A. Correlation between early revascularization and major cardiac events demonstrated by ischemic myocardium in Japanese patients with stable coronary artery disease. J Cardiol 2017; 71:44-51. [PMID: 28732592 DOI: 10.1016/j.jjcc.2017.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/17/2017] [Accepted: 05/25/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is no report on correlation between early revascularization and the occurrence of major cardiac events (MCEs) except severe heart failure in Japanese patients with stable coronary artery disease (CAD). This study aimed to determine whether early revascularization affected the incidence of MCEs in Japanese patients with stable CAD. METHODS We retrospectively investigated 3581 stable CAD patients who underwent rest 201Tl and stress 99mTc-tetrofosmin myocardial perfusion single-photon emission computed tomography (SPECT) and provided three-year-prognostic data. The endpoint was the onset of MCEs consisting of cardiac death, non-fatal myocardial infarction, and unstable angina pectoris. On the basis of estimated propensity scores, patients who underwent revascularization within the first 60 days after the SPECT and those who did not were matched in a 1:1 ratio (n=450 per group). We compared MCE rates in relation to the amount of ischemic myocardium detected with the SPECT between the two groups. RESULTS The overall incidence of MCEs was not significantly different between the early-revascularization and no-early-revascularization groups (6.7% vs. 8.7%, p=0.2598). Nevertheless, the incidence of MCEs in the patients with ≤5% ischemia was significantly higher in the early-revascularization group than in the no-early-revascularization group (5.8% vs. 0.8%, p=0.0226). In contrast, the incidence of MCEs in the patients with >10% ischemia was significantly lower in the early-revascularization group than in the no-early-revascularization group (7.0% vs. 16.8%, p=0.0036). The incidence of MCEs in the patients with 6-10% ischemia, however, was not significantly different between the early-revascularization and no-early-revascularization groups (6.9% vs. 4.1%, p=0.3235). CONCLUSIONS Early revascularization possibly leads to the occurrence of MCEs related to the treatment procedure but may be a therapeutic strategy leading to improvement in prognosis in patients with moderate to severe ischemia.
Collapse
Affiliation(s)
- Shunichi Yoda
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan.
| | - Yusuke Hori
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Misa Hayase
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Takashi Mineki
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Takumi Hatta
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuyuki Suzuki
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Atsushi Hirayama
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
4
|
Chikamori T, Goto K, Hida S, Miyagawa M, Ishimura H, Uchida K, Fukuyama T, Mochizuki T, Yamashina A. Diagnostic performance of a semiconductor gamma-camera system as studied by multicenter registry. J Cardiol 2017; 69:449-455. [DOI: 10.1016/j.jjcc.2016.02.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 02/02/2016] [Accepted: 02/23/2016] [Indexed: 11/28/2022]
|
5
|
Yoda S, Nakanishi K, Tano A, Hori Y, Hayase M, Mineki T, Suzuki Y, Matsumoto N, Hirayama A. Prognostic Value of Major Cardiac Event Risk Score Estimated With Gated Myocardial Perfusion Imaging in Japanese Patients With Coronary Artery Disease. Int Heart J 2016; 57:408-16. [DOI: 10.1536/ihj.15-428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Shunichi Yoda
- Department of Cardiology, Nihon University School of Medicine
| | - Kanae Nakanishi
- Department of Cardiology, Nihon University School of Medicine
| | - Ayako Tano
- Department of Cardiology, Nihon University School of Medicine
| | - Yusuke Hori
- Department of Cardiology, Nihon University School of Medicine
| | - Misa Hayase
- Department of Cardiology, Nihon University School of Medicine
| | - Takashi Mineki
- Department of Cardiology, Nihon University School of Medicine
| | - Yasuyuki Suzuki
- Department of Cardiology, Nihon University School of Medicine
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University School of Medicine
| | | |
Collapse
|
6
|
Yoda S, Nakanishi K, Tano A, Hori Y, Suzuki Y, Matsumoto N, Hirayama A. Major cardiac event risk scores estimated with gated myocardial perfusion imaging in Japanese patients with coronary artery disease. J Cardiol 2015; 67:64-70. [PMID: 25982667 DOI: 10.1016/j.jjcc.2015.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 04/04/2015] [Accepted: 04/09/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND A Heart Risk Table has been reported as the first risk score based on nuclear cardiology to predict cardiac event rates in Japanese patients. However, there are no risk scores estimating risk of major cardiac events (MCEs) except severe heart failure. METHODS We retrospectively investigated 2579 patients with known or suspected coronary artery disease (CAD) who underwent rest (201)Tl and stress (99m)Tc-tetrofosmin myocardial perfusion single photon emission computed tomography between October 2004 and March 2011 and who had data on a 3-year follow-up. The perfusion images were analyzed with 20 segments of a five-point visual scoring model to estimate summed defect scores. The endpoint was the onset of MCEs consisting of cardiac death, non-fatal myocardial infarction and unstable angina pectoris. RESULTS During the 3-year follow-up, 171 patients (6.6%) experienced MCEs comprising cardiac death (n=78), non-fatal myocardial infarction (n=30), and unstable angina pectoris (n=63). The multivariate logistic regression analysis indicated age, diabetes, estimated glomerular filtration rate (eGFR), and summed stress scores (SSS) as independent predictors of the MCEs and age, stress ejection fraction, eGFR, and SSS as independent predictors of cardiac death. Those four predictors and coefficients corresponding to them were used to make two different risk equations: MCE risk (%/3 years)=1/{1+Exp[-(-3.176+0.018×age+0.602×diabetes-0.022×eGFR+0.051×SSS)]}×100 and cardiac death risk (%/3 years)=1/{1+Exp[-(-2.602+0.031×age-0.031×eGFR+0.038×SSS-0.029×stress ejection fraction)]}×100. CONCLUSION The risk scores obtained from this study are useful to predict MCEs in Japanese patients with CAD and are expected to be useful for management and informed consent of high-risk CAD patients.
Collapse
Affiliation(s)
- Shunichi Yoda
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan.
| | - Kanae Nakanishi
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Ayako Tano
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Yusuke Hori
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuyuki Suzuki
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Atsushi Hirayama
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
7
|
Yoda S, Nakanishi K, Tano A, Hori Y, Suzuki Y, Matsumoto N, Hirayama A. Significance of worsening renal function and nuclear cardiology for predicting cardiac death in patients with known or suspected coronary artery disease. J Cardiol 2015; 66:423-9. [PMID: 25703693 DOI: 10.1016/j.jjcc.2015.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 12/28/2014] [Accepted: 01/08/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Estimated glomerular filtration rates (eGFRs) at baseline are useful to determine the severity of renal function and to predict cardiac events. However, no studies aimed to demonstrate significance of eGFRs measured during follow-up and usefulness of combination with nuclear cardiology for prediction of cardiac death in patients with coronary artery disease (CAD). METHODS We retrospectively investigated 1739 patients with known/suspected CAD who underwent myocardial perfusion single photon emission computed tomography (SPECT), who had eGFRs measured at baseline and after one year and who underwent a three-year follow-up. The SPECT images were analyzed with the visual scoring model to estimate summed defect scores. Reduction in eGFRs (ΔeGFR) was defined as the difference between eGFRs measured after one year and at baseline. The endpoint of the follow-up was cardiac deaths within three years after the SPECT, which were identified with medical records or responses to posted questionnaires. RESULTS Cardiac death was observed in 54 of 1739 patients during the follow-up period (45.6±9.1 months). The multivariate Cox regression analysis showed baseline eGFRs, ΔeGFR, and summed stress scores to be significant independent variables for prediction of cardiac death. The area under receiver operating characteristic curves for detection of cardiac death was 0.677 for the baseline eGFR and 0.802 for the follow-up eGFR. Sensitivity of detection of cardiac death was significantly higher in the follow-up eGFR than in the baseline eGFR (p=0.0002). Combination of the best cut-off values, i.e. 9 for the summed stress scores and 10 for the ΔeGFR, which were suggested by receiver operating characteristic analysis, was useful for risk stratification of cardiac death both in patients with and without chronic kidney disease. CONCLUSION Baseline and follow-up eGFRs as well as nuclear variables are useful to predict cardiac death in patients with known/suspected CAD.
Collapse
Affiliation(s)
- Shunichi Yoda
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan.
| | - Kanae Nakanishi
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Ayako Tano
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Yusuke Hori
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuyuki Suzuki
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Atsushi Hirayama
- Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
8
|
Kiriyama T, Kumita SI, Moroi M, Nishimura T, Tamaki N, Hasebe N, Kikuchi K. Interpretative Variability and Its Impact on the Prognostic Value of Myocardial Fatty Acid Imaging in Asymptomatic Hemodialysis Patients in a Multicenter Trial in Japan. Circ J 2014; 79:153-60. [DOI: 10.1253/circj.cj-14-0646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Masao Moroi
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center
| | - Tsunehiko Nishimura
- Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Nagara Tamaki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine
| | - Naoyuki Hasebe
- Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University
| | - Kenjiro Kikuchi
- Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University
| |
Collapse
|