Cardiopulmonary transit time: A novel PET imaging biomarker of in vivo physiology for risk stratification of heart transplant recipients

Harms, Hendrik J.; Bravo, Paco E.; Bajaj, Navkaranbir; Zhou, Wunan; Gupta, Ankur; Tran, Trinh T.; Taqueti, Viviany R.; Hainer, Jon; Bibbo, Courtney; Dorbala, Sharmila; Blankstein, Ron; Mehra, Mandeep R.; Sørensen, Jens Nørkær; Givertz, Michael M.; Carli, Marcelo F. Di

doi:10.1007/s12350-020-02465-x

Cited by 5 publications

(12 citation statements)

References 24 publications

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“…Four studies presented stress MBF data by unit increments. 42 , 43 , 46 , 47 The pooled HR with its 95% confidence interval suggested that an increase in stress MBF by 1 mL/g/min is a protective factor for MACE (HR = 0.32; 95% CI, 0.18–0.57; I 2 = 62.9%, P heterogeneity = 0.044) (Fig. 2 ).…”

Section: Resultsmentioning

confidence: 98%

“… 44 Table S1 ( http://links.lww.com/CIR/A38 ) presents the quality of the evidence. One study scored 5 stars, 47 1 scored 7 stars, 45 3 scored 8 stars, 8 , 42 , 46 and 1 scored 9 stars. 43 …”

Section: Resultsmentioning

confidence: 99%

“…42–47 There were 3 prospective cohort studies 42–44 and 3 retrospective cohort studies, 45–47 for a total of 2326 patients and 300 MACEs. Three studies were from Europe, 42,43,47 1 was from Japan, 45 1 from North America, 46 and 1 international. 44 Table S1 (http://links.lww.com/CIR/A38) presents the quality of the evidence.…”

Section: Resultsmentioning

confidence: 99%

“…Of note, heterogeneity was significant in all analyses. The proportion of females was variable, from 22% 46 to 75%, 47 and the mean age also varies from 51 to 65 years. Since age and male sex are important risk factors for CAD, 9,10 there might be variable eligibility criteria among the studies that could limit the generalizability of the included studies and result in heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

“…The results suggest that quantification of stress MBF using PET/CT and CMR (either as unit increments or high/low) might have incremental predictive value for future MACEs in a population at intermediate to high cardiovascular CMRI indicates cardiac magnetic resonance imaging; CTMPI, computed tomography myocardial perfusion imaging; MBF, myocardial blood flow; PET, positron emission tomography. [42][43][44][45][46][47] risk. This is supported by a previous meta-analysis that applied different inclusion criteria than the present meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Significance of Myocardial Blood Flow Quantification for Major Adverse Cardiac Events: A Systematic Review and Meta-analysis

Pan

Yin

Tang

et al. 2022

Cardiology in Review

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Chronic coronary syndromes involve reduced myocardial blood flow (MBF). MBF is a reliable predictor of outcomes, independent of the presence of significant stenosis. Whether MBF can predict major adverse cardiac events (MACE) during long-term follow-up is unknown. PubMed, Embase, Cochrane, CNKI, and WANFANG were searched for papers published up to January 2021. The exposure was the incremental unit of stress MBF (mL/g/min) or low MBF versus high MBF. The imaging examinations included positron emission tomography/computed tomography and coronary magnetic resonance. The study outcome was the occurrence of MACE during follow-up, summarized as time-to-event hazard ratios (HRs) and 95% confidence intervals (CIs). Six studies (300 MACEs in 2326 patients) were included. Four studies presented stress MBF data by unit increments. The pooled HR showed that an increase in stress MBF by 1 mL/g/min is a protective factor for MACE (HR = 0.32; 95% CI, 0.18-0.57; I 2 = 62.9%, P heterogeneity = 0.044). Two studies reported stress MBF as low/high. The results showed that a high-stress MBF was protective against MACEs (HR = 0.43; 95% CI, 0.24-0.78; I 2 = 39.5%, P heterogeneity = 0.199). Quantification of stress MBF using positron emission tomography/computed tomography and coronary magnetic resonance might have incremental predictive value for future MACEs in a population at intermediate to high cardiovascular risk. The results will require validation in large prospective randomized controlled trials.

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