Quantitation of Poststress Change in Ventricular Morphology Improves Risk Stratification
Shape index and eccentricity index are measures of left ventricular morphology. Although both measures can be quantified with any stress imaging modality, they are not routinely evaluated during clinical interpretation. We assessed their independent associations with major adverse cardiovascular eve...
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| Veröffentlicht in: | Journal of Nuclear Medicine 2021-11, Vol.62 (11), p.1582-1590 |
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| creator | Miller, Robert J H Sharir, Tali Otaki, Yuka Gransar, Heidi Liang, Joanna X Einstein, Andrew J Fish, Mathews B Ruddy, Terrence D Kaufmann, Philipp A Sinusas, Albert J Miller, Edward J Bateman, Timothy M Dorbala, Sharmila Di Carli, Marcelo Tamarappoo, Balaji K Dey, Damini Berman, Daniel S Slomka, Piotr J |
| description | Shape index and eccentricity index are measures of left ventricular morphology. Although both measures can be quantified with any stress imaging modality, they are not routinely evaluated during clinical interpretation. We assessed their independent associations with major adverse cardiovascular events (MACE), including measures of poststress change in shape index and eccentricity index.
Patients undergoing SPECT myocardial perfusion imaging between 2009 and 2014 from the Registry of Fast Myocardial Perfusion Imaging with Next-Generation SPECT (REFINE SPECT) were studied. Shape index (ratio between the maximum left ventricular diameter in short axis and ventricular length) and eccentricity index (calculated from orthogonal diameters in short axis and length) were calculated in end-diastole at stress and rest. Multivariable analysis was performed to assess independent associations with MACE (death, nonfatal myocardial infarction, unstable angina, or late revascularization).
In total, 14,016 patients with a mean age of 64.3 ± 12.2 y (8,469 [60.4%] male were included. MACE occurred in 2,120 patients during a median follow-up of 4.3 y (interquartile range, 3.4-5.7). Rest, stress, and poststress change in shape and eccentricity indices were associated with MACE in unadjusted analyses (all
< 0.001). However, in multivariable models, only poststress change in shape index (adjusted hazard ratio, 1.38;
< 0.001) and eccentricity index (adjusted hazard ratio, 0.80;
= 0.033) remained associated with MACE.
Two novel measures, poststress change in shape index and eccentricity index, were independently associated with MACE and improved risk estimation. Changes in ventricular morphology have important prognostic utility and should be included in patient risk estimation after SPECT myocardial perfusion imaging. |
| doi_str_mv | 10.2967/jnumed.120.260141 |
| format | Article |
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Patients undergoing SPECT myocardial perfusion imaging between 2009 and 2014 from the Registry of Fast Myocardial Perfusion Imaging with Next-Generation SPECT (REFINE SPECT) were studied. Shape index (ratio between the maximum left ventricular diameter in short axis and ventricular length) and eccentricity index (calculated from orthogonal diameters in short axis and length) were calculated in end-diastole at stress and rest. Multivariable analysis was performed to assess independent associations with MACE (death, nonfatal myocardial infarction, unstable angina, or late revascularization).
In total, 14,016 patients with a mean age of 64.3 ± 12.2 y (8,469 [60.4%] male were included. MACE occurred in 2,120 patients during a median follow-up of 4.3 y (interquartile range, 3.4-5.7). Rest, stress, and poststress change in shape and eccentricity indices were associated with MACE in unadjusted analyses (all
< 0.001). However, in multivariable models, only poststress change in shape index (adjusted hazard ratio, 1.38;
< 0.001) and eccentricity index (adjusted hazard ratio, 0.80;
= 0.033) remained associated with MACE.
Two novel measures, poststress change in shape index and eccentricity index, were independently associated with MACE and improved risk estimation. Changes in ventricular morphology have important prognostic utility and should be included in patient risk estimation after SPECT myocardial perfusion imaging.</description><identifier>ISSN: 0161-5505</identifier><identifier>ISSN: 1535-5667</identifier><identifier>EISSN: 1535-5667</identifier><identifier>EISSN: 2159-662X</identifier><identifier>DOI: 10.2967/jnumed.120.260141</identifier><identifier>PMID: 33712535</identifier><language>eng</language><publisher>United States: Society of Nuclear Medicine</publisher><subject>Aged ; Angina ; Clinical Investigation ; Diameters ; Diastole ; Eccentricity ; Female ; Health hazards ; Heart ; Heart Ventricles - diagnostic imaging ; Humans ; Imaging ; Male ; Middle Aged ; Morphology ; Myocardial infarction ; Myocardial Perfusion Imaging ; Patients ; Perfusion ; Quantitation ; Risk ; Risk Assessment ; Single photon emission computed tomography ; Stress ; Tomography, Emission-Computed, Single-Photon ; Ventricle</subject><ispartof>Journal of Nuclear Medicine, 2021-11, Vol.62 (11), p.1582-1590</ispartof><rights>2021 by the Society of Nuclear Medicine and Molecular Imaging.</rights><rights>Copyright Society of Nuclear Medicine Nov 1, 2021</rights><rights>2021 by the Society of Nuclear Medicine and Molecular Imaging. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-5b8ed5734519e08659029f4db62fc8bdb4100cec33939a8d4aa17896a03365843</citedby><cites>FETCH-LOGICAL-c427t-5b8ed5734519e08659029f4db62fc8bdb4100cec33939a8d4aa17896a03365843</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33712535$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miller, Robert J H</creatorcontrib><creatorcontrib>Sharir, Tali</creatorcontrib><creatorcontrib>Otaki, Yuka</creatorcontrib><creatorcontrib>Gransar, Heidi</creatorcontrib><creatorcontrib>Liang, Joanna X</creatorcontrib><creatorcontrib>Einstein, Andrew J</creatorcontrib><creatorcontrib>Fish, Mathews B</creatorcontrib><creatorcontrib>Ruddy, Terrence D</creatorcontrib><creatorcontrib>Kaufmann, Philipp A</creatorcontrib><creatorcontrib>Sinusas, Albert J</creatorcontrib><creatorcontrib>Miller, Edward J</creatorcontrib><creatorcontrib>Bateman, Timothy M</creatorcontrib><creatorcontrib>Dorbala, Sharmila</creatorcontrib><creatorcontrib>Di Carli, Marcelo</creatorcontrib><creatorcontrib>Tamarappoo, Balaji K</creatorcontrib><creatorcontrib>Dey, Damini</creatorcontrib><creatorcontrib>Berman, Daniel S</creatorcontrib><creatorcontrib>Slomka, Piotr J</creatorcontrib><title>Quantitation of Poststress Change in Ventricular Morphology Improves Risk Stratification</title><title>Journal of Nuclear Medicine</title><addtitle>J Nucl Med</addtitle><description>Shape index and eccentricity index are measures of left ventricular morphology. Although both measures can be quantified with any stress imaging modality, they are not routinely evaluated during clinical interpretation. We assessed their independent associations with major adverse cardiovascular events (MACE), including measures of poststress change in shape index and eccentricity index.
Patients undergoing SPECT myocardial perfusion imaging between 2009 and 2014 from the Registry of Fast Myocardial Perfusion Imaging with Next-Generation SPECT (REFINE SPECT) were studied. Shape index (ratio between the maximum left ventricular diameter in short axis and ventricular length) and eccentricity index (calculated from orthogonal diameters in short axis and length) were calculated in end-diastole at stress and rest. Multivariable analysis was performed to assess independent associations with MACE (death, nonfatal myocardial infarction, unstable angina, or late revascularization).
In total, 14,016 patients with a mean age of 64.3 ± 12.2 y (8,469 [60.4%] male were included. MACE occurred in 2,120 patients during a median follow-up of 4.3 y (interquartile range, 3.4-5.7). Rest, stress, and poststress change in shape and eccentricity indices were associated with MACE in unadjusted analyses (all
< 0.001). However, in multivariable models, only poststress change in shape index (adjusted hazard ratio, 1.38;
< 0.001) and eccentricity index (adjusted hazard ratio, 0.80;
= 0.033) remained associated with MACE.
Two novel measures, poststress change in shape index and eccentricity index, were independently associated with MACE and improved risk estimation. Changes in ventricular morphology have important prognostic utility and should be included in patient risk estimation after SPECT myocardial perfusion imaging.</description><subject>Aged</subject><subject>Angina</subject><subject>Clinical Investigation</subject><subject>Diameters</subject><subject>Diastole</subject><subject>Eccentricity</subject><subject>Female</subject><subject>Health hazards</subject><subject>Heart</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Humans</subject><subject>Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morphology</subject><subject>Myocardial infarction</subject><subject>Myocardial Perfusion Imaging</subject><subject>Patients</subject><subject>Perfusion</subject><subject>Quantitation</subject><subject>Risk</subject><subject>Risk Assessment</subject><subject>Single photon emission computed tomography</subject><subject>Stress</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Ventricle</subject><issn>0161-5505</issn><issn>1535-5667</issn><issn>1535-5667</issn><issn>2159-662X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1rHCEUhiW0JNs0PyA3RehNbyb16OjoTaAs_Qik9DvkThzH2XU7q1t1Avn3Nd00pL0S8Tmv55wHoVMgZ1SJ7vUmzFs3nAGtd0GghQO0AM54w4XonqAFAQEN54QfoWc5bwghQkp5iI4Y64BWcIGuv8wmFF9M8THgOOLPMZdckssZL9cmrBz2AV-5UJK382QS_hjTbh2nuLrFF9tdijcu468-_8TfSqopo7d_sp6jp6OZsju5P4_Rj3dvvy8_NJef3l8s31w2tqVdaXgv3cA71nJQjkjBFaFqbIde0NHKfuhbIMQ6y5hiysihNQY6qYQhjAkuW3aMzve5u7mvy7B3nZpJ75LfmnSro_H635fg13oVb7QUQOu3NeDVfUCKv2aXi976bN00meDinDXlBKgA0UFFX_6HbuKcQh2vUoqBYlKqSsGesinmnNz40AwQfedN773p6k3vvdWaF4-neKj4K4r9BhNMll4</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Miller, Robert J H</creator><creator>Sharir, Tali</creator><creator>Otaki, Yuka</creator><creator>Gransar, Heidi</creator><creator>Liang, Joanna X</creator><creator>Einstein, Andrew J</creator><creator>Fish, Mathews B</creator><creator>Ruddy, Terrence D</creator><creator>Kaufmann, Philipp A</creator><creator>Sinusas, Albert J</creator><creator>Miller, Edward J</creator><creator>Bateman, Timothy M</creator><creator>Dorbala, Sharmila</creator><creator>Di Carli, Marcelo</creator><creator>Tamarappoo, Balaji K</creator><creator>Dey, Damini</creator><creator>Berman, Daniel S</creator><creator>Slomka, Piotr J</creator><general>Society of Nuclear Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202111</creationdate><title>Quantitation of Poststress Change in Ventricular Morphology Improves Risk Stratification</title><author>Miller, Robert J H ; 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Although both measures can be quantified with any stress imaging modality, they are not routinely evaluated during clinical interpretation. We assessed their independent associations with major adverse cardiovascular events (MACE), including measures of poststress change in shape index and eccentricity index.
Patients undergoing SPECT myocardial perfusion imaging between 2009 and 2014 from the Registry of Fast Myocardial Perfusion Imaging with Next-Generation SPECT (REFINE SPECT) were studied. Shape index (ratio between the maximum left ventricular diameter in short axis and ventricular length) and eccentricity index (calculated from orthogonal diameters in short axis and length) were calculated in end-diastole at stress and rest. Multivariable analysis was performed to assess independent associations with MACE (death, nonfatal myocardial infarction, unstable angina, or late revascularization).
In total, 14,016 patients with a mean age of 64.3 ± 12.2 y (8,469 [60.4%] male were included. MACE occurred in 2,120 patients during a median follow-up of 4.3 y (interquartile range, 3.4-5.7). Rest, stress, and poststress change in shape and eccentricity indices were associated with MACE in unadjusted analyses (all
< 0.001). However, in multivariable models, only poststress change in shape index (adjusted hazard ratio, 1.38;
< 0.001) and eccentricity index (adjusted hazard ratio, 0.80;
= 0.033) remained associated with MACE.
Two novel measures, poststress change in shape index and eccentricity index, were independently associated with MACE and improved risk estimation. Changes in ventricular morphology have important prognostic utility and should be included in patient risk estimation after SPECT myocardial perfusion imaging.</abstract><cop>United States</cop><pub>Society of Nuclear Medicine</pub><pmid>33712535</pmid><doi>10.2967/jnumed.120.260141</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Freely accessible e-journals; Alma/SFX Local Collection |
| subjects | Aged Angina Clinical Investigation Diameters Diastole Eccentricity Female Health hazards Heart Heart Ventricles - diagnostic imaging Humans Imaging Male Middle Aged Morphology Myocardial infarction Myocardial Perfusion Imaging Patients Perfusion Quantitation Risk Risk Assessment Single photon emission computed tomography Stress Tomography, Emission-Computed, Single-Photon Ventricle |
| title | Quantitation of Poststress Change in Ventricular Morphology Improves Risk Stratification |
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