Significance of Increased Oxygen Extraction Fraction in Five-Year Prognosis of Major Cerebral Arterial Occlusive Diseases
In major cerebral arterial occlusive diseases, patients with increased oxygen extraction fraction (OEF), which is measured with PET, may be at increased risk for cerebral ischemia. However, the clinical significance of increased OEF remains unclear. This study investigated whether increased OEF is a...
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| Veröffentlicht in: | The Journal of nuclear medicine (1978) 1999-12, Vol.40 (12), p.1992-1998 |
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| container_title | The Journal of nuclear medicine (1978) |
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| creator | Yamauchi, Hiroshi Fukuyama, Hidenao Nagahama, Yasuhiro Nabatame, Hidehiko Ueno, Makoto Nishizawa, Sadahiko Konishi, Junji Shio, Hideo |
| description | In major cerebral arterial occlusive diseases, patients with increased oxygen extraction fraction (OEF), which is measured with PET, may be at increased risk for cerebral ischemia. However, the clinical significance of increased OEF remains unclear. This study investigated whether increased OEF is an independent predictor of 5-y risk of subsequent stroke.
We prospectively evaluated the relationship between the regional hemodynamic status of cerebral circulation and the subsequent risk of stroke in 40 patients with symptomatic internal carotid or middle cerebral arterial occlusive diseases who underwent PET. Patients were divided into two hemodynamic categories according to the mean hemispheric value of OEF-in the hemisphere supplied by the artery with symptomatic disease: one group with increased OEF and one with normal OEF. All patients were followed for 5 y with medical treatment until the recurrence of stroke or death.
During 5 y, 11 total and 9 ipsilateral ischemic strokes occurred. The incidences of all ischemic strokes in patients with increased OEF and in those with normal OEF were 5 of 7 and 6 of 33 patients, respectively. There were 4 ipsilateral ischemic strokes in patients with increased OEF and 5 in those with normal OEF. Kaplan-Meier analysis revealed that the risks of all stroke and ipsilateral ischemic stroke in patients with increased OEF were significantly higher than in those with normal OEF (log-rank test; P |
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We prospectively evaluated the relationship between the regional hemodynamic status of cerebral circulation and the subsequent risk of stroke in 40 patients with symptomatic internal carotid or middle cerebral arterial occlusive diseases who underwent PET. Patients were divided into two hemodynamic categories according to the mean hemispheric value of OEF-in the hemisphere supplied by the artery with symptomatic disease: one group with increased OEF and one with normal OEF. All patients were followed for 5 y with medical treatment until the recurrence of stroke or death.
During 5 y, 11 total and 9 ipsilateral ischemic strokes occurred. The incidences of all ischemic strokes in patients with increased OEF and in those with normal OEF were 5 of 7 and 6 of 33 patients, respectively. There were 4 ipsilateral ischemic strokes in patients with increased OEF and 5 in those with normal OEF. Kaplan-Meier analysis revealed that the risks of all stroke and ipsilateral ischemic stroke in patients with increased OEF were significantly higher than in those with normal OEF (log-rank test; P<0.0002 and P<0.0018, respectively). Multivariate analysis with the Cox proportional hazards model showed that increased OEF significantly increased stroke recurrence: the relative risk was 7.2 (95% confidence interval [CI], 2.0-25.5; P<0.005) for all stroke and 6.4 (95% CI, 1.6-26.1; P<0.01) for ipsilateral stroke. An increase in the absolute OEF value was a better predictor of recurrent ischemic stroke than was OEF asymmetry.
These findings suggest that an increased OEF is an independent predictor of 5-y risk of subsequent stroke. Identification of patients with increased OEF may have clinical significance in preventing recurrent stroke.</description><identifier>ISSN: 0161-5505</identifier><identifier>EISSN: 1535-5667</identifier><identifier>PMID: 10616876</identifier><identifier>CODEN: JNMEAQ</identifier><language>eng</language><publisher>Reston, VA: Soc Nuclear Med</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood Volume ; Brain Ischemia - diagnostic imaging ; Cerebrovascular Circulation ; Cerebrovascular Disorders - diagnostic imaging ; Cerebrovascular Disorders - metabolism ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Nervous system ; Oxygen Consumption ; Prognosis ; Radionuclide investigations ; Recurrence ; Risk Factors ; Stroke - diagnostic imaging ; Tomography, Emission-Computed</subject><ispartof>The Journal of nuclear medicine (1978), 1999-12, Vol.40 (12), p.1992-1998</ispartof><rights>2000 INIST-CNRS</rights><rights>Copyright Society of Nuclear Medicine Dec 1999</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1235705$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10616876$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamauchi, Hiroshi</creatorcontrib><creatorcontrib>Fukuyama, Hidenao</creatorcontrib><creatorcontrib>Nagahama, Yasuhiro</creatorcontrib><creatorcontrib>Nabatame, Hidehiko</creatorcontrib><creatorcontrib>Ueno, Makoto</creatorcontrib><creatorcontrib>Nishizawa, Sadahiko</creatorcontrib><creatorcontrib>Konishi, Junji</creatorcontrib><creatorcontrib>Shio, Hideo</creatorcontrib><title>Significance of Increased Oxygen Extraction Fraction in Five-Year Prognosis of Major Cerebral Arterial Occlusive Diseases</title><title>The Journal of nuclear medicine (1978)</title><addtitle>J Nucl Med</addtitle><description>In major cerebral arterial occlusive diseases, patients with increased oxygen extraction fraction (OEF), which is measured with PET, may be at increased risk for cerebral ischemia. However, the clinical significance of increased OEF remains unclear. This study investigated whether increased OEF is an independent predictor of 5-y risk of subsequent stroke.
We prospectively evaluated the relationship between the regional hemodynamic status of cerebral circulation and the subsequent risk of stroke in 40 patients with symptomatic internal carotid or middle cerebral arterial occlusive diseases who underwent PET. Patients were divided into two hemodynamic categories according to the mean hemispheric value of OEF-in the hemisphere supplied by the artery with symptomatic disease: one group with increased OEF and one with normal OEF. All patients were followed for 5 y with medical treatment until the recurrence of stroke or death.
During 5 y, 11 total and 9 ipsilateral ischemic strokes occurred. The incidences of all ischemic strokes in patients with increased OEF and in those with normal OEF were 5 of 7 and 6 of 33 patients, respectively. There were 4 ipsilateral ischemic strokes in patients with increased OEF and 5 in those with normal OEF. Kaplan-Meier analysis revealed that the risks of all stroke and ipsilateral ischemic stroke in patients with increased OEF were significantly higher than in those with normal OEF (log-rank test; P<0.0002 and P<0.0018, respectively). Multivariate analysis with the Cox proportional hazards model showed that increased OEF significantly increased stroke recurrence: the relative risk was 7.2 (95% confidence interval [CI], 2.0-25.5; P<0.005) for all stroke and 6.4 (95% CI, 1.6-26.1; P<0.01) for ipsilateral stroke. An increase in the absolute OEF value was a better predictor of recurrent ischemic stroke than was OEF asymmetry.
These findings suggest that an increased OEF is an independent predictor of 5-y risk of subsequent stroke. Identification of patients with increased OEF may have clinical significance in preventing recurrent stroke.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood Volume</subject><subject>Brain Ischemia - diagnostic imaging</subject><subject>Cerebrovascular Circulation</subject><subject>Cerebrovascular Disorders - diagnostic imaging</subject><subject>Cerebrovascular Disorders - metabolism</subject><subject>Female</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system</subject><subject>Oxygen Consumption</subject><subject>Prognosis</subject><subject>Radionuclide investigations</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Stroke - diagnostic imaging</subject><subject>Tomography, Emission-Computed</subject><issn>0161-5505</issn><issn>1535-5667</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpd0EtLw0AUBeAgitbHX5BBRNwE5nUnybLU-gClgm5chcnkpp2STupMovbfO8WK4GrO4ruH4ewlIwYCUlAq209GlCmWAlA4So5DWFJKVZ7nh8kRo4qpPFOjZPNi58421mhnkHQNeXDGow5Yk9nXZo6OTL96r01vO0duf4ON2X5g-obak2ffzV0XbNieP-ll58kEPVZet2Tse_Q2hpkx7RDiDbmxYdsfTpODRrcBz3bvSfJyO32d3KePs7uHyfgxXfBC9SlvDCgsONNgABqmhDIVSsV5ZaRQlDNeSdmYihZQSwkqlwVgY5TQNTBxklz9tK599z5g6MuVDQbbVjvshlCqQuQygzzCi39w2Q3exZ-VnBWcCyqziM53aKhWWJdrb1fab8rfPSO43AEdjG4bH2e14c9xARmFyK5_2MLOF5_WY-kG08Yxt6VLt5I00pIVBRffhgWM_g</recordid><startdate>19991201</startdate><enddate>19991201</enddate><creator>Yamauchi, Hiroshi</creator><creator>Fukuyama, Hidenao</creator><creator>Nagahama, Yasuhiro</creator><creator>Nabatame, Hidehiko</creator><creator>Ueno, Makoto</creator><creator>Nishizawa, Sadahiko</creator><creator>Konishi, Junji</creator><creator>Shio, Hideo</creator><general>Soc Nuclear Med</general><general>Society of Nuclear Medicine</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>19991201</creationdate><title>Significance of Increased Oxygen Extraction Fraction in Five-Year Prognosis of Major Cerebral Arterial Occlusive Diseases</title><author>Yamauchi, Hiroshi ; Fukuyama, Hidenao ; Nagahama, Yasuhiro ; Nabatame, Hidehiko ; Ueno, Makoto ; Nishizawa, Sadahiko ; Konishi, Junji ; Shio, Hideo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h296t-2fc56e921a5c55f1636cbe4622bc4360212b44fcb095d44568495efc63ad513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood Volume</topic><topic>Brain Ischemia - diagnostic imaging</topic><topic>Cerebrovascular Circulation</topic><topic>Cerebrovascular Disorders - diagnostic imaging</topic><topic>Cerebrovascular Disorders - metabolism</topic><topic>Female</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system</topic><topic>Oxygen Consumption</topic><topic>Prognosis</topic><topic>Radionuclide investigations</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Stroke - diagnostic imaging</topic><topic>Tomography, Emission-Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamauchi, Hiroshi</creatorcontrib><creatorcontrib>Fukuyama, Hidenao</creatorcontrib><creatorcontrib>Nagahama, Yasuhiro</creatorcontrib><creatorcontrib>Nabatame, Hidehiko</creatorcontrib><creatorcontrib>Ueno, Makoto</creatorcontrib><creatorcontrib>Nishizawa, Sadahiko</creatorcontrib><creatorcontrib>Konishi, Junji</creatorcontrib><creatorcontrib>Shio, Hideo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of nuclear medicine (1978)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamauchi, Hiroshi</au><au>Fukuyama, Hidenao</au><au>Nagahama, Yasuhiro</au><au>Nabatame, Hidehiko</au><au>Ueno, Makoto</au><au>Nishizawa, Sadahiko</au><au>Konishi, Junji</au><au>Shio, Hideo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Significance of Increased Oxygen Extraction Fraction in Five-Year Prognosis of Major Cerebral Arterial Occlusive Diseases</atitle><jtitle>The Journal of nuclear medicine (1978)</jtitle><addtitle>J Nucl Med</addtitle><date>1999-12-01</date><risdate>1999</risdate><volume>40</volume><issue>12</issue><spage>1992</spage><epage>1998</epage><pages>1992-1998</pages><issn>0161-5505</issn><eissn>1535-5667</eissn><coden>JNMEAQ</coden><abstract>In major cerebral arterial occlusive diseases, patients with increased oxygen extraction fraction (OEF), which is measured with PET, may be at increased risk for cerebral ischemia. However, the clinical significance of increased OEF remains unclear. This study investigated whether increased OEF is an independent predictor of 5-y risk of subsequent stroke.
We prospectively evaluated the relationship between the regional hemodynamic status of cerebral circulation and the subsequent risk of stroke in 40 patients with symptomatic internal carotid or middle cerebral arterial occlusive diseases who underwent PET. Patients were divided into two hemodynamic categories according to the mean hemispheric value of OEF-in the hemisphere supplied by the artery with symptomatic disease: one group with increased OEF and one with normal OEF. All patients were followed for 5 y with medical treatment until the recurrence of stroke or death.
During 5 y, 11 total and 9 ipsilateral ischemic strokes occurred. The incidences of all ischemic strokes in patients with increased OEF and in those with normal OEF were 5 of 7 and 6 of 33 patients, respectively. There were 4 ipsilateral ischemic strokes in patients with increased OEF and 5 in those with normal OEF. Kaplan-Meier analysis revealed that the risks of all stroke and ipsilateral ischemic stroke in patients with increased OEF were significantly higher than in those with normal OEF (log-rank test; P<0.0002 and P<0.0018, respectively). Multivariate analysis with the Cox proportional hazards model showed that increased OEF significantly increased stroke recurrence: the relative risk was 7.2 (95% confidence interval [CI], 2.0-25.5; P<0.005) for all stroke and 6.4 (95% CI, 1.6-26.1; P<0.01) for ipsilateral stroke. An increase in the absolute OEF value was a better predictor of recurrent ischemic stroke than was OEF asymmetry.
These findings suggest that an increased OEF is an independent predictor of 5-y risk of subsequent stroke. Identification of patients with increased OEF may have clinical significance in preventing recurrent stroke.</abstract><cop>Reston, VA</cop><pub>Soc Nuclear Med</pub><pmid>10616876</pmid><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Blood Volume Brain Ischemia - diagnostic imaging Cerebrovascular Circulation Cerebrovascular Disorders - diagnostic imaging Cerebrovascular Disorders - metabolism Female Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Nervous system Oxygen Consumption Prognosis Radionuclide investigations Recurrence Risk Factors Stroke - diagnostic imaging Tomography, Emission-Computed |
| title | Significance of Increased Oxygen Extraction Fraction in Five-Year Prognosis of Major Cerebral Arterial Occlusive Diseases |
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