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Journal of Nuclear Cardiology
Published in: Journal of Nuclear Cardiology 1/2022

01-02-2022 | Arterial Diseases | ORIGINAL ARTICLE

Papillary muscle ischemia on high-resolution cine imaging of nitrogen-13 ammonia positron emission tomography: Association with myocardial flow reserve and prognosis in coronary artery disease

Authors: Risako Nakao, MD, Michinobu Nagao, MD, PhD, Atsushi Yamamoto, MD, Kenji Fukushima, MD, PhD, Eri Watanabe, MD, PhD, Shuji Sakai, MD, PhD, Nobuhisa Hagiwara, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 1/2022

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Abstract

Background

The evaluation of papillary muscle (PM) perfusion through existing perfusion imaging, including single-photon emission computed tomography and magnetic resonance imaging, is not possible. Therefore, this study sought to investigate the detection of PM ischemia in coronary artery disease (CAD) using nitrogen-13 (N-13) ammonia positron emission tomography (NH3 PET) and its association with global myocardial flow reserve (MFR) and major adverse cardiac events (MACE).

Methods

Data of adenosine-stress NH3 PET for 263 consecutive patients with known or suspected CAD were retrospectively analyzed. PM ischemia was defined as the absence of PM accumulation under stress conditions and PM presence at rest on high-resolution cine imaging derived from PET-computed tomography scanner with time-of-flight technology. The primary outcome was MACE.

Results

Of 263 patients, 30 experienced mean follow-up period of 910 days (MACE), while 31 (11.8%) presented PM ischemia. Compared to patients without PM ischemia, those with PM ischemia reported a significantly lower global MFR and a significantly higher rate of MACE (P < .0001).

Conclusion

NH3 PET enables the detection of PM ischemia in approximately 10% of patients with known or suspected CAD. PM ischemia is associated with reduced global MFR and is an important sign in predicting prognosis.
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Metadata
Title
Papillary muscle ischemia on high-resolution cine imaging of nitrogen-13 ammonia positron emission tomography: Association with myocardial flow reserve and prognosis in coronary artery disease
Authors
Risako Nakao, MD
Michinobu Nagao, MD, PhD
Atsushi Yamamoto, MD
Kenji Fukushima, MD, PhD
Eri Watanabe, MD, PhD
Shuji Sakai, MD, PhD
Nobuhisa Hagiwara, MD, PhD
Publication date
01-02-2022
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 1/2022
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-020-02231-z

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