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Prognostic value of cardiac hybrid imaging integrating single-photon emission computed tomography with coronary computed tomography angiography.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Publication date 2011
Author Pazhenkottil Aju P, Nkoulou René N, Ghadri Jelena-Rima, Herzog Bernhard A, Buechel Ronny R, Küest Silke M, Wolfrum Mathias, Fiechter Michael, Husmann Lars, Gaemperli Oliver, Kaufmann Philipp A, Budoff Matthew J, Cademartiri Filippo, Callister Tracy Q, Chang Hyuk-Jae, Delago Augustin, Dunning Allison, Hadamitzky Martin, Hausleiter Jorg, Kaufmann Philipp, Lin Fay, Maffei Erica, Min James K, Shaw Leslee J, Chow Benjamin J W,
Project Entwicklung einer neuen Hybrid-Bildgebungs-Methode zur nicht invasiven kardialen Diagnostik
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Original article (peer-reviewed)

Journal European heart journal
Volume (Issue) 32(12)
Page(s) 1465 - 71
Title of proceedings European heart journal
DOI 10.1093/eurheartj/ehr047


Aims Although cardiac hybrid imaging, fusing single-photon emission computed tomography (SPECT) myocardial perfusion imaging with coronary computed tomography angiography (CCTA), provides important complementary diagnostic information for coronary artery disease (CAD) assessment, no prognostic data exist on the predictive value of cardiac hybrid imaging. Hence, the aim of this study was to assess the prognostic value of hybrid SPECT/CCTA images. Methods and results Of 335 consecutive patients undergoing a 1-day stress/rest (99m)Tc-tetrofosmin SPECT and a CCTA, acquired on stand-alone scanners and fused to obtain cardiac hybrid images, follow-up was obtained in 324 patients (97%). Survival free of all-cause death or non-fatal myocardial infarction (MI) and free of major adverse cardiac events (MACE: death, MI, unstable angina requiring hospitalization, coronary revascularizations) was determined using the Kaplan-Meier method for the following groups: (i) stenosis by CCTA and matching reversible SPECT defect; (ii) unmatched CCTA and SPECT finding; and (iii) normal finding by CCTA and SPECT. Cox's proportional hazard regression was used to identify independent predictors for cardiac events. At a median follow-up of 2.8 years (25th-75th percentile: 1.9-3.6), 69 MACE occurred in 47 patients, including 20 death/MI. A corresponding matched hybrid image finding was associated with a significantly higher death/MI incidence (P < 0.005) and proved to be an independent predictor for MACE. The annual death/MI rate was 6.0, 2.8, and 1.3% for patients with matched, unmatched, and normal findings. Conclusion Cardiac hybrid imaging allows risk stratification in patients with known or suspected CAD. A matched defect on hybrid image is a strong predictor of MACE.