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Maurer A, Sustar A, Giannopoulos AA, Grünig H, Bakula A, Patriki D, von Felten E, Messerli M, Pazhenkottil AP, Gebhard C, Kaufmann PA, Buechel RR, Fuchs TA. Left ventricular function and volumes from gated [ 13N]-ammonia positron emission tomography myocardial perfusion imaging: A prospective head-to-head comparison against CMR using a hybrid PET/MR device. J Nucl Cardiol 2023; 30:616-625. [PMID: 35819716 DOI: 10.1007/s12350-022-03029-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Positron emission tomography (PET) myocardial perfusion imaging (MPI) can be used to evaluate left ventricular (LV) volumes and function. We performed a head-to-head comparison of LV function and volumes obtained simultaneously using [13N]-ammonia-PET and cardiac magnetic resonance (CMR), with the latter serving as the reference standard. METHODS AND RESULTS In this prospective study, 51 patients underwent [13N]-ammonia-PET MPI and CMR using a hybrid PET/MR device. Left ventricular end-systolic volumes (LVESV), end-diastolic volumes (LVEDV), stroke volumes (LVSV), ejection fractions (LVEF), and segmental wall motion were analyzed for both methods and were compared using correlational and Bland-Altman (BA) analysis; segmental wall motion was compared using ANOVA. The agreement between [13N]-ammonia-PET and CMR for LVEF was good, with minimal bias (- .6%) and narrow BA limits of agreement (- 7.9% to 6.8%), but [13N]-ammonia-PET systematically underestimated LV volumes, with high bias in LVESV (- 11.2 ml), LVEDV (- 28.9 ml), and LVSV (- 17.5 ml). Mean segmental wall motion in [13N]-ammonia-PET differed significantly among the corresponding normokinetic (6.6 ± 2 mm), hypokinetic (5.1 ± 2 mm), and akinetic (3.3 ± 2 mm) segments in CMR (P < .01). CONCLUSION LVEF and LV wall motion can be accurately assessed using [13N]-ammonia-PET MPI, although LV volumes are significantly underestimated compared to CMR.
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Affiliation(s)
- Alexander Maurer
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Aleksandra Sustar
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Hannes Grünig
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Adam Bakula
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Dimitri Patriki
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Elia von Felten
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Catherine Gebhard
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Tobias A Fuchs
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
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Chaturvedi H, Issac R, Sharma SK, Gupta R. Progressive left and right heart dysfunction in coronavirus disease-19: Prospective echocardiographic evaluation. Eur Heart J Cardiovasc Imaging 2021; 23:319-325. [PMID: 34904153 PMCID: PMC8754756 DOI: 10.1093/ehjci/jeab268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/01/2021] [Indexed: 02/06/2023] Open
Abstract
Aims Cardiac dysfunction in coronavirus disease-19 (COVID-19) has been reported during acute phase but serial changes have not been well studied. To determine serial changes in type and severity of echocardiographic left and right heart functions we performed a prospective study. Methods and results Successive COVID-19 patients at discharge from the hospital from June to December 2020 were enrolled. Clinical details were obtained and echocardiography was performed using Philips IE33X-Matrix. Follow-up evaluation was performed after 3 months. In total, 1789 COVID-19 patients were evaluated. Baseline echocardiography was performed in 1000 eligible patients (men 611, women 389). Mean age was 50.2 ± 15 years, hypertension was in 44.0%, diabetes in 49.4%, and coronary disease in 10.8%. COVID-19 was mild in 47.0%, moderate in 39.5%, and severe in 13.5%. Baseline cardiac parameters were more impaired in severe vs. moderate or mild COVID-19. At 3 months, in 632 patients where baseline and follow-up data were available, decline was observed in select left [left ventricular internal diameter in diastole +0.9 ± 0.2 mm, left atrial volume +7.6 ± 0.1 mL/m2, mitral E/e′ +4.8 ± 0.1, and left ventricular ejection fraction (LVEF) −3.7 ± 0.2%] and right [right ventricular internal diameter in diastole +2.1 ± 0.1 mm, right atrial internal dimension +1.6 ± 0.1 mm, tricuspid Vmax +1.0 ± 0.1 cm, and tricuspid annulus plane systolic excursion (TAPSE) −2.7 ± 0.2 mm] heart variables (P < 0.001). Compared to mild COVID-19, decline was significantly greater in moderate/severe disease, LVEF −1.1 ± 0.3 vs. −3.8 ± 0.3%; mitral E/e′ +3.2 ± 0.1 vs. +4.8 ± 0.1, tricuspid Vmax +0.3 ± 0.1 vs. +1.0 ± 0.1 cm, and TAPSE −0.7 ± 0.2 vs. −2.7 ± 0.2 mm (P < 0.001). Conclusion This study shows impaired cardiac functions in severe and moderate COVID-19 compared to mild at hospital discharge and progressive decline in left and right heart functions at 3 months. Impairment is significantly greater in patients with moderate to severe disease.
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Affiliation(s)
- Hemant Chaturvedi
- Department of Noninvasive Cardiology, Eternal Heart Care Center and Research Institute, Jaipur 302017, India
| | - Rohan Issac
- Department of Noninvasive Cardiology, Eternal Heart Care Center and Research Institute, Jaipur 302017, India
| | - Sanjeev Kumar Sharma
- Department of Cardiology, Eternal Heart Care Center and Research Institute, Jaipur 302017, India
| | - Rajeev Gupta
- Department of Cardiology, Eternal Heart Care Center and Research Institute, Jaipur 302017, India
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Henein MY, Grönlund C, Tossavainen E, Söderberg S, Gonzalez M, Lindqvist P. Right and left heart dysfunction predict mortality in pulmonary hypertension. Clin Physiol Funct Imaging 2015; 37:45-51. [PMID: 26096286 DOI: 10.1111/cpf.12266] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 05/04/2015] [Indexed: 12/21/2022]
Abstract
In pulmonary hypertension (PH), the right heart dysfunction is a strong predictor of adverse clinical outcome, while the role of the left heart is not fully determined. The aim of this study was to identify predictors of mortality in precapillary PH including measures of both right and left heart function. We studied 34 patients (mean age 64 ± 13, range 31-82 years, 24 females) with precapillary PH, all of whom underwent detailed Doppler echocardiographic examination of the right and left heart function using conventional and speckle-tracking echocardiography. Patients were followed up for up to 8 years (mean 4·2 ± 1·9 years). At follow-up, 16 patients survived. Left ventricular (LV) filling time (P = 0·007), pulmonary artery acceleration time (P = 0·009), right atrial pressure (RAP) (P<0·001) and tricuspid regurgitation (TR) severity (P = 0·007) were worse in the deceased group. RV global longitudinal strain (GLS) (P = 0·001), RAP (P≤0·001), LV filling time (P<0·001) and TR severity (P<0·001) were the most accurate predictors, having the largest AUC (>0·65) and carried the highest risk for mortality (P<0·001 for all). The strongest predictors of mortality in precapillary PH indirectly reflect both left and right heart dysfunction including atrial structure and function disturbances. While an interaction pattern is observed, it needs to be confirmed in a larger cohort.
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Affiliation(s)
- Michael Y Henein
- Department of Cardiology, Heart Centre, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christer Grönlund
- Department of Biomedical Engineering - R&D, Radiation sciences, Umeå University, Umeå, Sweden
| | - Erik Tossavainen
- Department of Cardiology, Heart Centre, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Cardiology, Heart Centre, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Manuel Gonzalez
- Department of Cardiology, Heart Centre, Umeå University, Umeå, Sweden
| | - Per Lindqvist
- Department of Clinical Physiology, Heart Centre, Umeå University, Umeå, Sweden.,Department of Surgical and Peri-Operative Sciences, Umeå University, Umeå, Sweden
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