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Right and left ventricular uptake with Rb-82 PET myocardial perfusion imaging: Markers of left main or 3 vessel disease

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Relative myocardial perfusion imaging may underestimate severity of coronary disease (CAD), particularly in cases of balanced ischemia. Can quantification of peak left (LV) and right (RV) ventricular Rb-82 uptake measurements identify patients with left main or 3 vessel disease?

Methods

Patients (N = 169) who underwent Rb-82 PET MPI and coronary angiography were categorized as having no significant coronary stenosis (n = 60), 1 or 2 vessel disease (n = 81), or left main disease/3 vessel disease (n = 28), based on angiography. Maximal LV and RV ventricular myocardial Rb-82 uptake was measured during stress and rest.

Results

Failure to augment LV uptake by ≥ 8500 Bq/cc at stress, predicted left main or 3 vessel disease with a sensitivity of 93% and specificity of 61% (area under curve = 0.83). A ≥10% increase in RV: LV uptake ratios with stress over rest was 93% specific (area under curve = 0.74) for left main or 3 vessel disease. These indices incrementally predicted left main or 3 vessel disease compared to models including age, gender, cardiac risk factors, and summed stress and difference scores.

Conclusion

Quantifying maximal rest and stress LV and RV uptake with PET myocardial perfusion imaging may independently and incrementally identify patients with left main or 3 vessel disease.

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Acknowledgments

The authors extend their gratitude to Quintin Armour, May Aung, Sandina Jamieson, Ann Guo, Kim Gardner, and Matt Raegele for their technical assistance and expertise.

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Authors and Affiliations

  1. Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada

    Arun Abraham MBBS, FRACP, Malek Kass MD, FRCPC, Terrence D. Ruddy MD, FRCPC, FACC, FASNC, Robert A. deKemp PhD, Andrea K. Y. Lee, Michael C. Ling MD, FRCPC, Andrew Ha MD, Rob S. Beanlands MD, FRCPC, FACC & Benjamin J. W. Chow MD, FRCPC, FACC, FASNC

  2. Department of Epidemiology, University of Ottawa, Ottawa, ON, Canada

    Arun Abraham MBBS, FRACP

  3. Department of Radiology, Ottawa Hospital, Ottawa, ON, Canada

    Terrence D. Ruddy MD, FRCPC, FACC, FASNC, Rob S. Beanlands MD, FRCPC, FACC & Benjamin J. W. Chow MD, FRCPC, FACC, FASNC

Authors
  1. Arun Abraham MBBS, FRACP
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  2. Malek Kass MD, FRCPC
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  3. Terrence D. Ruddy MD, FRCPC, FACC, FASNC
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  4. Robert A. deKemp PhD
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  5. Andrea K. Y. Lee
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  6. Michael C. Ling MD, FRCPC
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  7. Andrew Ha MD
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  8. Rob S. Beanlands MD, FRCPC, FACC
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  9. Benjamin J. W. Chow MD, FRCPC, FACC, FASNC
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Corresponding author

Correspondence to Benjamin J. W. Chow MD, FRCPC, FACC, FASNC.

Additional information

Arun Abraham is supported by the Whit and Heather Tucker Research Fellowship. Rob Beanlands is a Career Investigator supported by the Heart and Stroke Foundation of Ontario. Benjamin Chow is supported by CIHR New Investigator Award #MSH-83718, and receives research and fellowship support from GE Healthcare and educational support from TeraRecon Inc.

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Abraham, A., Kass, M., Ruddy, T.D. et al. Right and left ventricular uptake with Rb-82 PET myocardial perfusion imaging: Markers of left main or 3 vessel disease. J. Nucl. Cardiol. 17, 52–60 (2010). https://doi.org/10.1007/s12350-009-9153-2

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  • DOI: https://doi.org/10.1007/s12350-009-9153-2

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