Subacute cardiac rubidium-82 positron emission tomography (82Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI

Adam Ali Ghotbi; Andreas Kjaer; Lars Nepper-Christensen; Kiril Aleksov Ahtarovski; Jacob Thomsen Lønborg; Niels Vejlstrup; Kasper Kyhl; Thomas Emil Christensen; Thomas Engstrøm; Henning Kelbæk; Lene Holmvang; Lia E Bang; Rasmus Sejersten Ripa; Philip Hasbak

doi:10.1007/s12350-016-0694-x

Subacute cardiac rubidium-82 positron emission tomography (⁸²Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI

Adam Ali Ghotbi, Andreas Kjaer, Lars Nepper-Christensen, Kiril Aleksov Ahtarovski, Jacob Thomsen Lønborg, Niels Vejlstrup, Kasper Kyhl, Thomas Emil Christensen, Thomas Engstrøm, Henning Kelbæk, Lene Holmvang, Lia E Bang, Rasmus Sejersten Ripa, Philip Hasbak

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Abstract

BACKGROUND: Determining infarct size and myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) is important when assessing the efficacy of new reperfusion strategies. We investigated whether rest (82)Rb-PET myocardial perfusion imaging can estimate area at risk, final infarct size, and myocardial salvage index when compared to cardiac SPECT and magnetic resonance (CMR).

METHODS: Twelve STEMI patients were injected with (99m)Tc-Sestamibi intravenously immediate prior to reperfusion. SPECT, (82)Rb-PET, and CMR imaging were performed post-reperfusion and at a 3-month follow-up. An automated algorithm determined area at risk, final infarct size, and hence myocardial salvage index.

RESULTS: SPECT, CMR, and PET were performed 2.2 ± 0.5, 34 ± 8.5, and 32 ± 24.4 h after reperfusion, respectively. Mean (± SD) area at risk were 35.2 ± 16.6%, 34.7 ± 11.3%, and 28.1 ± 16.1% of the left ventricle (LV) in SPECT, CMR, and PET, respectively, P = 0.04 for difference. Mean final infarct size estimates were 12.3 ± 15.4%, 13.7 ± 10.4%, and 11.9 ± 14.6% of the LV in SPECT, CMR, and PET imaging, respectively, P = .72. Myocardial salvage indices were 0.64 ± 0.33 (SPECT), 0.65 ± 0.20 (CMR), and 0.63 ± 0.28 (PET), (P = .78).

CONCLUSIONS: (82)Rb-PET underestimates area at risk in patients with STEMI when compared to SPECT and CMR. However, our findings suggest that PET imaging seems feasible when assessing the clinical important parameters of final infarct size and myocardial salvage index, although with great variability, in a selected STEMI population with large infarcts. These findings should be confirmed in a larger population.

Originalsprog	Engelsk
Tidsskrift	Journal of Nuclear Cardiology
Vol/bind	25
Udgave nummer	3
Sider (fra-til)	970–981
ISSN	1071-3581
DOI	https://doi.org/10.1007/s12350-016-0694-x
Status	Udgivet - 1 jun. 2018

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10.1007/s12350-016-0694-xLicens: CC BY

Subacute cardiac rubidium-82 positron emission tomography (82Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMIForlagets udgivne version, 723 KBLicens: CC BY

Citationsformater

Ghotbi, A. A., Kjaer, A., Nepper-Christensen, L., Ahtarovski, K. A., Lønborg, J. T., Vejlstrup, N., Kyhl, K., Christensen, T. E., Engstrøm, T., Kelbæk, H., Holmvang, L., Bang, L. E., Ripa, R. S., & Hasbak, P. (2018). Subacute cardiac rubidium-82 positron emission tomography (⁸²Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI. Journal of Nuclear Cardiology, 25(3), 970–981. https://doi.org/10.1007/s12350-016-0694-x

Subacute cardiac rubidium-82 positron emission tomography (⁸²Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI. / Ghotbi, Adam Ali; Kjaer, Andreas; Nepper-Christensen, Lars et al.

I: Journal of Nuclear Cardiology, Bind 25, Nr. 3, 01.06.2018, s. 970–981.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Ghotbi, AA, Kjaer, A, Nepper-Christensen, L, Ahtarovski, KA, Lønborg, JT, Vejlstrup, N, Kyhl, K, Christensen, TE, Engstrøm, T, Kelbæk, H, Holmvang, L, Bang, LE, Ripa, RS & Hasbak, P 2018, 'Subacute cardiac rubidium-82 positron emission tomography (⁸²Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI', Journal of Nuclear Cardiology, bind 25, nr. 3, s. 970–981. https://doi.org/10.1007/s12350-016-0694-x

@article{55ea882781d441329678eca9cf68469a,

title = "Subacute cardiac rubidium-82 positron emission tomography (82Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI",

abstract = "BACKGROUND: Determining infarct size and myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) is important when assessing the efficacy of new reperfusion strategies. We investigated whether rest (82)Rb-PET myocardial perfusion imaging can estimate area at risk, final infarct size, and myocardial salvage index when compared to cardiac SPECT and magnetic resonance (CMR).METHODS: Twelve STEMI patients were injected with (99m)Tc-Sestamibi intravenously immediate prior to reperfusion. SPECT, (82)Rb-PET, and CMR imaging were performed post-reperfusion and at a 3-month follow-up. An automated algorithm determined area at risk, final infarct size, and hence myocardial salvage index.RESULTS: SPECT, CMR, and PET were performed 2.2 ± 0.5, 34 ± 8.5, and 32 ± 24.4 h after reperfusion, respectively. Mean (± SD) area at risk were 35.2 ± 16.6%, 34.7 ± 11.3%, and 28.1 ± 16.1% of the left ventricle (LV) in SPECT, CMR, and PET, respectively, P = 0.04 for difference. Mean final infarct size estimates were 12.3 ± 15.4%, 13.7 ± 10.4%, and 11.9 ± 14.6% of the LV in SPECT, CMR, and PET imaging, respectively, P = .72. Myocardial salvage indices were 0.64 ± 0.33 (SPECT), 0.65 ± 0.20 (CMR), and 0.63 ± 0.28 (PET), (P = .78).CONCLUSIONS: (82)Rb-PET underestimates area at risk in patients with STEMI when compared to SPECT and CMR. However, our findings suggest that PET imaging seems feasible when assessing the clinical important parameters of final infarct size and myocardial salvage index, although with great variability, in a selected STEMI population with large infarcts. These findings should be confirmed in a larger population.",

author = "Ghotbi, {Adam Ali} and Andreas Kjaer and Lars Nepper-Christensen and Ahtarovski, {Kiril Aleksov} and L{\o}nborg, {Jacob Thomsen} and Niels Vejlstrup and Kasper Kyhl and Christensen, {Thomas Emil} and Thomas Engstr{\o}m and Henning Kelb{\ae}k and Lene Holmvang and Bang, {Lia E} and Ripa, {Rasmus Sejersten} and Philip Hasbak",

year = "2018",

month = jun,

day = "1",

doi = "10.1007/s12350-016-0694-x",

language = "English",

volume = "25",

pages = "970–981",

journal = "Journal of Nuclear Cardiology",

issn = "1071-3581",

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number = "3",

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TY - JOUR

T1 - Subacute cardiac rubidium-82 positron emission tomography (82Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI

AU - Ghotbi, Adam Ali

AU - Kjaer, Andreas

AU - Nepper-Christensen, Lars

AU - Ahtarovski, Kiril Aleksov

AU - Lønborg, Jacob Thomsen

AU - Vejlstrup, Niels

AU - Kyhl, Kasper

AU - Christensen, Thomas Emil

AU - Engstrøm, Thomas

AU - Kelbæk, Henning

AU - Holmvang, Lene

AU - Bang, Lia E

AU - Ripa, Rasmus Sejersten

AU - Hasbak, Philip

PY - 2018/6/1

Y1 - 2018/6/1

N2 - BACKGROUND: Determining infarct size and myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) is important when assessing the efficacy of new reperfusion strategies. We investigated whether rest (82)Rb-PET myocardial perfusion imaging can estimate area at risk, final infarct size, and myocardial salvage index when compared to cardiac SPECT and magnetic resonance (CMR).METHODS: Twelve STEMI patients were injected with (99m)Tc-Sestamibi intravenously immediate prior to reperfusion. SPECT, (82)Rb-PET, and CMR imaging were performed post-reperfusion and at a 3-month follow-up. An automated algorithm determined area at risk, final infarct size, and hence myocardial salvage index.RESULTS: SPECT, CMR, and PET were performed 2.2 ± 0.5, 34 ± 8.5, and 32 ± 24.4 h after reperfusion, respectively. Mean (± SD) area at risk were 35.2 ± 16.6%, 34.7 ± 11.3%, and 28.1 ± 16.1% of the left ventricle (LV) in SPECT, CMR, and PET, respectively, P = 0.04 for difference. Mean final infarct size estimates were 12.3 ± 15.4%, 13.7 ± 10.4%, and 11.9 ± 14.6% of the LV in SPECT, CMR, and PET imaging, respectively, P = .72. Myocardial salvage indices were 0.64 ± 0.33 (SPECT), 0.65 ± 0.20 (CMR), and 0.63 ± 0.28 (PET), (P = .78).CONCLUSIONS: (82)Rb-PET underestimates area at risk in patients with STEMI when compared to SPECT and CMR. However, our findings suggest that PET imaging seems feasible when assessing the clinical important parameters of final infarct size and myocardial salvage index, although with great variability, in a selected STEMI population with large infarcts. These findings should be confirmed in a larger population.

AB - BACKGROUND: Determining infarct size and myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) is important when assessing the efficacy of new reperfusion strategies. We investigated whether rest (82)Rb-PET myocardial perfusion imaging can estimate area at risk, final infarct size, and myocardial salvage index when compared to cardiac SPECT and magnetic resonance (CMR).METHODS: Twelve STEMI patients were injected with (99m)Tc-Sestamibi intravenously immediate prior to reperfusion. SPECT, (82)Rb-PET, and CMR imaging were performed post-reperfusion and at a 3-month follow-up. An automated algorithm determined area at risk, final infarct size, and hence myocardial salvage index.RESULTS: SPECT, CMR, and PET were performed 2.2 ± 0.5, 34 ± 8.5, and 32 ± 24.4 h after reperfusion, respectively. Mean (± SD) area at risk were 35.2 ± 16.6%, 34.7 ± 11.3%, and 28.1 ± 16.1% of the left ventricle (LV) in SPECT, CMR, and PET, respectively, P = 0.04 for difference. Mean final infarct size estimates were 12.3 ± 15.4%, 13.7 ± 10.4%, and 11.9 ± 14.6% of the LV in SPECT, CMR, and PET imaging, respectively, P = .72. Myocardial salvage indices were 0.64 ± 0.33 (SPECT), 0.65 ± 0.20 (CMR), and 0.63 ± 0.28 (PET), (P = .78).CONCLUSIONS: (82)Rb-PET underestimates area at risk in patients with STEMI when compared to SPECT and CMR. However, our findings suggest that PET imaging seems feasible when assessing the clinical important parameters of final infarct size and myocardial salvage index, although with great variability, in a selected STEMI population with large infarcts. These findings should be confirmed in a larger population.

U2 - 10.1007/s12350-016-0694-x

DO - 10.1007/s12350-016-0694-x

M3 - Journal article

C2 - 27743299

SN - 1071-3581

VL - 25

SP - 970

EP - 981

JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

IS - 3

ER -

Subacute cardiac rubidium-82 positron emission tomography (82Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI

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Subacute cardiac rubidium-82 positron emission tomography (⁸²Rb-PET) to assess myocardial area at risk, final infarct size, and myocardial salvage after STEMI