title: Prognostic value of rubidium-82 positron emission tomography in patients after heart transplant.
abstract: BACKGROUND
  Cardiac allograft vasculopathy is a key prognostic determinant after heart transplant. Detection and risk stratification of patients with cardiac allograft vasculopathy are problematic. Positron emission tomography using rubidium-82 allows quantification of absolute myocardial blood flow and may have utility for risk stratification in this population.
  
  
  RESULTS
  Patients with a history of heart transplant undergoing dipyridamole rubidium-82 positron emission tomography were prospectively enrolled. Myocardial perfusion and left ventricular ejection fraction were recorded. Absolute flow quantification at rest and after dipyridamole stress as well as the ratio of mean global flow at stress and at rest, termed myocardial flow reserve, were calculated. Patients were followed for all-cause death, acute coronary syndrome, and heart failure hospitalization. A total of 140 patients (81% men; median age, 62 years; median follow-up, 18.2 months) were included. There were 14 events during follow-up (9 deaths, 1 acute coronary syndrome, and 4 heart failure admissions). In addition to baseline clinical variables (estimated glomerular filtration rate, previously documented cardiac allograft vasculopathy), relative perfusion defects, mean myocardial flow reserve, and mean stress myocardial blood flow were significant predictors of adverse outcome.
  
  
  CONCLUSIONS
  Abnormalities on rubidium-82 positron emission tomography were predictors of adverse events in heart transplant patients. Larger prospective studies are required to confirm these findings.
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Mc Ardle
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Davies
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Small
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Terrence D
authors.initials: TD
authors.lastname: Ruddy
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Girish
authors.initials: G
authors.lastname: Dwivedi
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Yeung
authors.initials: Y
authors.lastname: Yam
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Haissam
authors.initials: H
authors.lastname: Haddad
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Mielniczuk
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Ellamae
authors.initials: E
authors.lastname: Stadnick
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Renee
authors.initials: R
authors.lastname: Hessian
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Ann
authors.initials: A
authors.lastname: Guo
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Rob S
authors.initials: RS
authors.lastname: Beanlands
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: deKemp
authors.affiliation: From the Division of Cardiology, Department of Medicine (B.A.M.A., R.A.D., G.R.S., T.D.R., G.D., Y.Y., H.H., L.M.M., E.S., R.H., R.S.B., B.J.W.C.), National Cardiac PET Center (B.A.M.A., R.A.D., T.D.R., R.H., A.G., R.S.B., R.A.d., B.J.W.C.), and Division of Cardiology, Department of Medicine, Cardiovascular Research Methods Center (L.C.), University of Ottawa Heart Institute. Ottawa, Canada. bchow@ottawaheart.ca.
authors.forename: Benjamin J W
authors.initials: BJ
authors.lastname: Chow
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology / Q000401:mortality; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000628:therapy; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012307:Risk Factors; D012414:Rubidium Radioisotopes; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes
keywords: heart transplantation; positron emission tomography; prognosis