Guiding coronary revascularization using PET stress myocardial perfusion imaging: The proof is in the pudding

Srivastava, Ajay; Ananthasubramaniam, Karthik

doi:10.1007/s12350-016-0479-2

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…Therefore, when interpreting CFR, changes in MBF rest due to alterations in metabolic demand need to be considered. [36][37][38] Altogether, the results of our study raise the question if absolute MBF stress may be an earlier and more robust marker for CAD in patients with ESRD than CFR. This hypothesis is additionally supported by the finding that only MBF stress was significantly correlated with LVEF (rest) but not CFR.…”

Section: Discussionmentioning

confidence: 79%

“…In former studies absolute MBF stress already shown to be more accurate than CFR in detecting CAD in non-CKD patients. 35,37 Interestingly, MBF rest was higher in patients without or minimal CACS and low cPB, a finding which is most probably caused by the higher frequency of females in these groups. Most studies report of higher MBF rest in females, although the mechanisms of this phenomenon remain uncertain.…”

Section: Discussionmentioning

confidence: 95%

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Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound

Wenning

Vrachimis

Pavenstädt

et al. 2021

Journal of Nuclear Cardiology

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Background. Imaging-based measures of atherosclerosis such as coronary artery calcium score (CACS) and coronary flow reserve (CFR) as well as carotid atherosclerotic plaque burden (cPB) are predictors of cardiovascular events in the general population. The objective of this study was to correlate CACS, cPB, myocardial blood flow (MBF), and CFR in patients with end-stage renal disease (ESRD).Methods and results. 39 patients (mean age 53 ± 12 years) with ESRD prior to kidney transplantation were enrolled. MBF and CFR were quantified at baseline and under hyperemia by 13 N-NH 3 -PET/CT. CACS was calculated from low-dose CT scans acquired for PET attenuation correction. cPB was assessed by 3D ultrasound. Uni-and multivariate regression analyses between these and clinical parameters were performed. Median follow-up time for clinical events was 4.4 years. Kaplan-Meier survival estimates with log-rank test were performed with regards to cardiovascular (CV) events and death of any cause. CACS and cPB were associated in ESRD patients (r = 0.48; p £ 0.01). While cPB correlated with age (r = 0.43; p < 0.01), CACS did not. MBF stress was negatively associated with age (r = 0.44; p < 0.01) and time on dialysis (r = 0.42; p < 0.01). There were negative correlations between MBF stress and CACS (r = 2 0.62; p < 0.001) and between MBF stress and cPB (r = 2 0.43; p < 0.01). Age and CACS were the strongest predictors for MBF stress . CFR was impaired (< 2.0) in eight patients who also presented with higher cPB and higher CACS compared to those with a CFR > 2.0 (p = 0.06 and p = 0.4). In contrast to MBF stress , there was neither a significant correlation Electronic supplementary material The online version of this article (https://doi.between CFR and CACS (r = 2 0.2; p = 0.91) nor between CFR and cPB (r = 2 0.1; p = 0.55). CV event-free survival was associated with reduced CFR and MBF stress (p = 0.001 and p < 0.001) but not with cPB or CACS. Conclusions.CACS, cPB, and MBF stress are associated in patients with ESRD. Atherosclerosis is earlier detected by MBF stress than by CFR. CV event-free survival is associated with impaired CFR and MBF stress . (J Nucl Cardiol 2020)

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 95%

Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound

Wenning

Vrachimis

Pavenstädt

et al. 2021

Journal of Nuclear Cardiology

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“…The current limiting factor of PET myocardial perfusion imaging (MPI) is availability of tracers, especially in clinical sites without cyclotron [ 5 , 6 ]. Based on technical superiority of PET over SPECT for myocardial perfusion imaging and feasibility for quantitation of myocardial blood flow in absolute terms [ 7 , 8 ], the development of new radiotracers for PET MPI may lead to wider use of PET diagnostic imaging in cardiology.…”

Section: Introductionmentioning

confidence: 99%

Preclinical evaluation of [18F]SYN1 and [18F]SYN2, novel radiotracers for PET myocardial perfusion imaging

Krajewski,

Steczek,

Gotowicz

et al. 2024

EJNMMI Res

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Background Positron emission tomography (PET) is now an established diagnostic method for myocardial perfusion imaging (MPI) in coronary artery disease, which is the main cause of death globally. The available tracers show several limitations, therefore, the 18F-labelled tracer is in high demand nowadays. The preclinical studies on normal Wistar rats aimed to characterise two potential, novel radiotracers, [18F]SYN1 and [18F]SYN2, to evaluate which is a better candidate for PET MPI cardiotracer. Results The dynamic microPET images showed rapid myocardial uptake for both tracers. However, the uptake was higher and also stable for [18F]SYN2, with an average standardized uptake value of 3.8. The biodistribution studies confirmed that [18F]SYN2 uptake in the cardiac muscle was high and stable (3.02%ID/g at 15 min and 2.79%ID/g at 6 h) compared to [18F]SYN1 (1.84%ID/g at 15 min and 0.32%ID/g at 6 h). The critical organs determined in dosimetry studies were the small intestine and the kidneys. The estimated effective dose for humans was 0.00714 mSv/MBq for [18F]SYN1 and 0.0109 mSv/MBq for [18F]SYN2. The tested dose level of 2 mg/kg was considered to be the No Observed Adverse Effect Level (NOAEL) for both candidates. The better results were achieved for [18F]SYN2, therefore, further preclinical studies were conducted only for this tracer. Radioligand binding assays showed significant responses in 3 from 68 assays: muscarinic acetylcholine M1 and M2 receptors and potassium channel hERG. The compound was mostly metabolised via an oxidative N-dealkylation, while the fluor substituent was not separated from the molecule. Conclusion [18F]SYN2 showed a favourable pharmacodynamic and pharmacokinetic profile, which enabled a clear visualization of the heart in microPET. The compound was well-tolerated in studies in normal rats with moderate radiation exposure. The results encourage further exploration of [18F]SYN2 in clinical studies.

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“…Besides that, patients are exposed to less radiation owing to the short half-lives of positron isotopes [ 6 , 7 ]. Hence, the need for and use of PET applications in healthcare facilities is increasing tremendously [ 3 , 8 , 9 , 10 ]. In 2016, the American Society of Nuclear Cardiology and the Society of Nuclear Medicine and Molecular Imaging published a joint position statement on the clinical indications for the significant underutilization of myocardial perfusion PET in America [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Research Progress on 18F-Labeled Agents for Imaging of Myocardial Perfusion with Positron Emission Tomography

Mou

Zhang

2017

Molecules

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Coronary artery disease (CAD) is the leading cause of death in the world. Myocardial perfusion imaging (MPI) plays a significant role in non-invasive diagnosis and prognosis of CAD. However, neither single-photon emission computed tomography nor positron emission tomography clinical MPI agents can absolutely satisfy the demands of clinical practice. In the past decades, tremendous developments happened in the field of 18F-labeled MPI tracers. This review summarizes the current state of 18F-labeled MPI tracers, basic research data of those tracers, and the future direction of MPI tracer research.

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Guiding coronary revascularization using PET stress myocardial perfusion imaging: The proof is in the pudding

Cited by 4 publications

References 28 publications

Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound

Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound

Preclinical evaluation of [18F]SYN1 and [18F]SYN2, novel radiotracers for PET myocardial perfusion imaging

Research Progress on 18F-Labeled Agents for Imaging of Myocardial Perfusion with Positron Emission Tomography

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