Prediction of arrhythmic events with positron emission tomography: PAREPET study design and methods

In medically-treated patients with ischemic cardiomyopathy, myocardial viability is associated with a worse prognosis than scar. The risk is especially great with hibernating myocardium (chronic regional dysfunction with reduced resting flow), and the excess mortality appears to be due to sudden cardiac death (SCD). Hibernating myocardium also results in sympathetic nerve dysfunction, which has been independently associated with risk of SCD.

PAREPET is a prospective, observational cohort study funded by NHLBI. It is designed to determine whether hibernating myocardium and/or inhomogeneity of sympathetic innervation by positron emission tomography imaging identifies patients with ischemic cardiomyopathy who are at high risk for SCD and cardiovascular mortality.

Patients with documented ischemic cardiomyopathy, an ejection fraction of

The PAREPET study will prospectively determine whether the amount of viable dysfunction myocardium and/or cardiac sympathetic dysinnervation is associated with the risk of SCD. It is anticipated that the results of this trial will more specifically identify myocardial substrates of SCD. This will help target therapies intended to reduce arrhythmic death to those patients with the greatest likelihood of benefit.