Prognostic utility of splenic response ratio in dipyridamole PET myocardial perfusion imaging

Karan Bami, Shrankhala Tewari, Fadi Guirguis, Linda Garrard, Ann Guo, Alomgir Hossain, Terrence D. Ruddy, Rob S.B. Beanlands, Robert A. DeKemp, Benjamin J.W. Chow, Girish Dwivedi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Cardiac magnetic resonance perfusion studies with adenosine stress have shown that splenic response can identify patients with inadequate pharmacologic stress. We investigate the incremental prognostic impact of splenic response ratio (SRR) in patients with normal Rubidium (Rb)-82 PET myocardial perfusion imaging (MPI). Methods: Consecutive patients undergoing dipyridamole Rb-82 PET MPI for the evaluation of coronary artery disease were screened. Spleen and liver Rb-82 activity was measured and the SRR was calculated: SRR = (Spleen stress/Liver stress)/(Spleen rest/Liver rest). Major adverse cardiac events (MACE) were determined at 1 year of follow-up in patients with normal summed stress score and normal summed difference score. Results: Of the 839 patients screened, the spleen was visualized in 703 (84%) of scans. There was significantly higher MACE observed in splenic non-responders vs splenic responders in both the normal SSS (7.8% vs 2.9%, P = .027) and the normal SDS groups (7.4% vs 2.2%, P = .014). In multivariate analysis in patients with normal SDS, splenic response was a significant, independent predictor of MACE (HR 2.97, 95% CI 1.10 to 8.04, P = .033). Conclusions: SRR is a novel imaging metric to identify patients with sub-maximal vasodilator stress and an incremental prognostic marker in patients with normal SDS and SSS (Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01128023).

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalJournal of Nuclear Cardiology
DOIs
Publication statusE-pub ahead of print - 12 Apr 2018

Fingerprint

Myocardial Perfusion Imaging
Dipyridamole
Rubidium
Spleen
Liver
Vasodilator Agents
Adenosine
Coronary Artery Disease
Magnetic Resonance Spectroscopy
Multivariate Analysis
Perfusion
Clinical Trials

Cite this

Bami, Karan ; Tewari, Shrankhala ; Guirguis, Fadi ; Garrard, Linda ; Guo, Ann ; Hossain, Alomgir ; Ruddy, Terrence D. ; Beanlands, Rob S.B. ; DeKemp, Robert A. ; Chow, Benjamin J.W. ; Dwivedi, Girish. / Prognostic utility of splenic response ratio in dipyridamole PET myocardial perfusion imaging. In: Journal of Nuclear Cardiology. 2018 ; pp. 1-10.
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title = "Prognostic utility of splenic response ratio in dipyridamole PET myocardial perfusion imaging",
abstract = "Background: Cardiac magnetic resonance perfusion studies with adenosine stress have shown that splenic response can identify patients with inadequate pharmacologic stress. We investigate the incremental prognostic impact of splenic response ratio (SRR) in patients with normal Rubidium (Rb)-82 PET myocardial perfusion imaging (MPI). Methods: Consecutive patients undergoing dipyridamole Rb-82 PET MPI for the evaluation of coronary artery disease were screened. Spleen and liver Rb-82 activity was measured and the SRR was calculated: SRR = (Spleen stress/Liver stress)/(Spleen rest/Liver rest). Major adverse cardiac events (MACE) were determined at 1 year of follow-up in patients with normal summed stress score and normal summed difference score. Results: Of the 839 patients screened, the spleen was visualized in 703 (84{\%}) of scans. There was significantly higher MACE observed in splenic non-responders vs splenic responders in both the normal SSS (7.8{\%} vs 2.9{\%}, P = .027) and the normal SDS groups (7.4{\%} vs 2.2{\%}, P = .014). In multivariate analysis in patients with normal SDS, splenic response was a significant, independent predictor of MACE (HR 2.97, 95{\%} CI 1.10 to 8.04, P = .033). Conclusions: SRR is a novel imaging metric to identify patients with sub-maximal vasodilator stress and an incremental prognostic marker in patients with normal SDS and SSS (Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01128023).",
keywords = "Major adverse cardiac events, myocardial perfusion imaging, positron emission tomography, prognosis, splenic response ratio, summed difference score",
author = "Karan Bami and Shrankhala Tewari and Fadi Guirguis and Linda Garrard and Ann Guo and Alomgir Hossain and Ruddy, {Terrence D.} and Beanlands, {Rob S.B.} and DeKemp, {Robert A.} and Chow, {Benjamin J.W.} and Girish Dwivedi",
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Bami, K, Tewari, S, Guirguis, F, Garrard, L, Guo, A, Hossain, A, Ruddy, TD, Beanlands, RSB, DeKemp, RA, Chow, BJW & Dwivedi, G 2018, 'Prognostic utility of splenic response ratio in dipyridamole PET myocardial perfusion imaging' Journal of Nuclear Cardiology, pp. 1-10. https://doi.org/10.1007/s12350-018-1269-9

Prognostic utility of splenic response ratio in dipyridamole PET myocardial perfusion imaging. / Bami, Karan; Tewari, Shrankhala; Guirguis, Fadi; Garrard, Linda; Guo, Ann; Hossain, Alomgir; Ruddy, Terrence D.; Beanlands, Rob S.B.; DeKemp, Robert A.; Chow, Benjamin J.W.; Dwivedi, Girish.

In: Journal of Nuclear Cardiology, 12.04.2018, p. 1-10.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic utility of splenic response ratio in dipyridamole PET myocardial perfusion imaging

AU - Bami, Karan

AU - Tewari, Shrankhala

AU - Guirguis, Fadi

AU - Garrard, Linda

AU - Guo, Ann

AU - Hossain, Alomgir

AU - Ruddy, Terrence D.

AU - Beanlands, Rob S.B.

AU - DeKemp, Robert A.

AU - Chow, Benjamin J.W.

AU - Dwivedi, Girish

PY - 2018/4/12

Y1 - 2018/4/12

N2 - Background: Cardiac magnetic resonance perfusion studies with adenosine stress have shown that splenic response can identify patients with inadequate pharmacologic stress. We investigate the incremental prognostic impact of splenic response ratio (SRR) in patients with normal Rubidium (Rb)-82 PET myocardial perfusion imaging (MPI). Methods: Consecutive patients undergoing dipyridamole Rb-82 PET MPI for the evaluation of coronary artery disease were screened. Spleen and liver Rb-82 activity was measured and the SRR was calculated: SRR = (Spleen stress/Liver stress)/(Spleen rest/Liver rest). Major adverse cardiac events (MACE) were determined at 1 year of follow-up in patients with normal summed stress score and normal summed difference score. Results: Of the 839 patients screened, the spleen was visualized in 703 (84%) of scans. There was significantly higher MACE observed in splenic non-responders vs splenic responders in both the normal SSS (7.8% vs 2.9%, P = .027) and the normal SDS groups (7.4% vs 2.2%, P = .014). In multivariate analysis in patients with normal SDS, splenic response was a significant, independent predictor of MACE (HR 2.97, 95% CI 1.10 to 8.04, P = .033). Conclusions: SRR is a novel imaging metric to identify patients with sub-maximal vasodilator stress and an incremental prognostic marker in patients with normal SDS and SSS (Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01128023).

AB - Background: Cardiac magnetic resonance perfusion studies with adenosine stress have shown that splenic response can identify patients with inadequate pharmacologic stress. We investigate the incremental prognostic impact of splenic response ratio (SRR) in patients with normal Rubidium (Rb)-82 PET myocardial perfusion imaging (MPI). Methods: Consecutive patients undergoing dipyridamole Rb-82 PET MPI for the evaluation of coronary artery disease were screened. Spleen and liver Rb-82 activity was measured and the SRR was calculated: SRR = (Spleen stress/Liver stress)/(Spleen rest/Liver rest). Major adverse cardiac events (MACE) were determined at 1 year of follow-up in patients with normal summed stress score and normal summed difference score. Results: Of the 839 patients screened, the spleen was visualized in 703 (84%) of scans. There was significantly higher MACE observed in splenic non-responders vs splenic responders in both the normal SSS (7.8% vs 2.9%, P = .027) and the normal SDS groups (7.4% vs 2.2%, P = .014). In multivariate analysis in patients with normal SDS, splenic response was a significant, independent predictor of MACE (HR 2.97, 95% CI 1.10 to 8.04, P = .033). Conclusions: SRR is a novel imaging metric to identify patients with sub-maximal vasodilator stress and an incremental prognostic marker in patients with normal SDS and SSS (Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01128023).

KW - Major adverse cardiac events

KW - myocardial perfusion imaging

KW - positron emission tomography

KW - prognosis

KW - splenic response ratio

KW - summed difference score

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U2 - 10.1007/s12350-018-1269-9

DO - 10.1007/s12350-018-1269-9

M3 - Article

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JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

SN - 1071-3581

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