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Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism
Published on: January 12, 2019
Mortality risk associated with ejection fraction differs across resting nuclear perfusion findings
Jamieson M Bourque1, Eric J Velazquez, Robert H Tuttle
1Division of Cardiology, Department of Internal Medicine, Duke University Health System, Durham, NC, USA. jamieson2@gmail.com
Summary
Left ventricular ejection fraction (LVEF) and nuclear summed rest score (SRS) independently predict mortality. An interaction exists, meaning a normal LVEF with high SRS indicates a poor prognosis similar to reduced LVEF.
Area of Science:
- Cardiology
- Nuclear Cardiology
- Cardiac Imaging
Background:
- Left ventricular ejection fraction (LVEF) is a key predictor of patient morbidity and mortality.
- Nuclear summed rest score (SRS) assesses myocardial perfusion defects and offers prognostic insights, but its long-term impact and interaction with LVEF require further study.
Purpose of the Study:
- To investigate if the mortality risk associated with LVEF varies across different levels of SRS in patients evaluated for ischemic heart disease.
Main Methods:
- Analysis of 3,187 patients undergoing cardiac catheterization and SPECT imaging.
- Utilized Cox proportional hazards modeling with a median follow-up of 3.1 years (maximum 8.1 years).
Main Results:
- Both increasing SRS and decreasing LVEF were independently linked to higher long-term mortality.
- A significant interaction (P = .032) was observed between SRS and LVEF.
- Patients with normal LVEF but high SRS had a prognosis comparable to those with reduced LVEF.
Conclusions:
- Resting perfusion imaging (SRS) provides crucial prognostic data impacting the interpretation of LVEF-related mortality risk.
- Future patient prognostication, risk stratification, and research should incorporate the interaction between SRS and LVEF.
