Dataset Information

Does quantification of [¹¹C]meta-hydroxyephedrine and [¹³N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy.

ABSTRACT:

Background

In ischemic cardiomyopathy patients, cardiac sympathetic nervous system dysfunction is a predictor of sudden cardiac arrest (SCA). This study compared abnormal innervation and perfusion measured by [¹¹C]meta-hydroxyephedrine (HED) vs [¹³N]ammonia (NH₃), conventional uptake vs parametric tracer analysis, and their SCA risk discrimination.

Methods

This is a sub-study analysis of the prospective PAREPET trial, which followed ischemic cardiomyopathy patients with reduced left ventricular ejection fraction (LVEF ≤ 35%) for events of SCA. Using n = 174 paired dynamic HED and NH₃ positron emission tomography (PET) scans, regional defect scores (%LV extent × severity) were calculated using HED and NH₃ uptake, as well as HED distribution volume and NH₃ myocardial blood flow by kinetic modeling.

Results

During 4.1 years follow-up, there were 27 SCA events. HED defects were larger than NH₃, especially in the lowest tertile of perfusion abnormality (P < .001). Parametric defects were larger than their respective tracer uptake defects (P < .001). SCA risk discrimination was not significantly improved with parametric or uptake mismatch (AUC = 0.73 or 0.70) compared to HED uptake defect scores (AUC = 0.67).

Conclusion

Quantification of HED distribution volume and NH₃ myocardial blood flow produced larger defects than their respective measures of tracer uptake, but did not lead to improved SCA risk stratification vs HED uptake alone.

SUBMITTER: Wang JZ

PROVIDER: S-EPMC8807773 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Does quantification of [<sup>11</sup>C]meta-hydroxyephedrine and [<sup>13</sup>N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy.

Wang Jean Z JZ Zelt Jason G E JGE Kaps Nicole N Lavallee Aaryn A Renaud Jennifer M JM Rotstein Benjamin B Beanlands Rob S B RSB Fallavollita James A JA Canty John M JM deKemp Robert A RA

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 20210802 2

<h4>Background</h4>In ischemic cardiomyopathy patients, cardiac sympathetic nervous system dysfunction is a predictor of sudden cardiac arrest (SCA). This study compared abnormal innervation and perfusion measured by [<sup>11</sup>C]meta-hydroxyephedrine (HED) vs [<sup>13</sup>N]ammonia (NH<sub>3</sub>), conventional uptake vs parametric tracer analysis, and their SCA risk discrimination.<h4>Methods</h4>This is a sub-study analysis of the prospective PAREPET trial, which followed ischemic cardio ...[more]

PMID: 34341953

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Project description:BackgroundThe standard reference region (RR) for amyloid-beta (Aβ) PET studies is the cerebellar grey matter (GMCB), while alternative RRs have mostly been utilized without prior validation against the gold standard. This study compared five commonly used RRs to gold standard plasma input-based quantification using the GMCB.MethodsThirteen subjects from a test-retest (TRT) study and 30 from a longitudinal study were retrospectively included (total: 17 Alzheimer's disease, 13 mild cognitive impairment, 13 controls). Dynamic [11C]PiB PET (90 min) and T1-weighted MR scans were co-registered and time-activity curves were extracted for cortical target regions and the following RRs: GMCB, whole cerebellum (WCB), white matter brainstem/pons (WMBS), whole brainstem (WBS) and eroded subcortical white matter (WMES). A two-tissue reversible plasma input model (2T4k_Vb) with GMCB as RR, reference Logan and the simplified reference tissue model were used to derive distribution volume ratios (DVRs), and standardized uptake value (SUV) ratios were calculated for 40-60 min and 60-90 min intervals. Parameter variability was evaluated using TRT scans, and correlations and agreements with the gold standard (DVR from 2T4k_Vb with GMCB RR) were also assessed. Next, longitudinal changes in SUVs (both intervals) were assessed for each RR. Finally, the ability to discriminate between visually Aβ positive and Aβ negative scans was assessed.ResultsAll RRs yielded stable TRT performance (max 5.1% variability), with WCB consistently showing lower variability. All approaches were able to discriminate between Aβ positive and Aβ negative scans, with highest effect sizes obtained for GMCB (range - 0.9 to - 0.7), followed by WCB (range - 0.8 to - 0.6). Furthermore, all approaches provided good correlations with the gold standard (r ≥ 0.78), while the highest bias (as assessed by the regression slope) was observed using WMES (range slope 0.52-0.67), followed by WBS (range slope 0.58-0.92) and WMBS (range slope 0.62-0.91). Finally, RR SUVs were stable across a period of 2.6 years for all except WBS and WMBS RRs (60-90 min interval).ConclusionsGMCB and WCB are considered the best RRs for quantifying amyloid burden using [11C]PiB PET.

Dataset Information

Does quantification of [¹¹C]meta-hydroxyephedrine and [¹³N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy.

Background

Methods

Results

Conclusion

Publications

Does quantification of [<sup>11</sup>C]meta-hydroxyephedrine and [<sup>13</sup>N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Does quantification of [11C]meta-hydroxyephedrine and [13N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy.

Background

Methods

Results

Conclusion

Publications

Does quantification of [<sup>11</sup>C]meta-hydroxyephedrine and [<sup>13</sup>N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Does quantification of [¹¹C]meta-hydroxyephedrine and [¹³N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy.