Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner
Abstract Background Inadequate coronary adenosine response is a potential cause for false negative ischemia testing. Recently, the splenic switch-off (SSO) sign has been identified as a promising tool to ascertain the efficacy of adenosine during vasodilator stress cardiovascular magnetic resonance...
| Váldodahkkit: | , , , , , , , , , , , , , |
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| Materiálatiipa: | Artihkal |
| Giella: | English |
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Elsevier
2021-01-01
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| Ráidu: | Journal of Cardiovascular Magnetic Resonance |
| Fáttát: | |
| Liŋkkat: | https://doi.org/10.1186/s12968-020-00696-y |
| _version_ | 1827268508373745664 |
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| author | Dimitri Patriki Elia von Felten Adam Bakula Andreas A. Giannopoulos Christel H. Kamani Moritz Schwyzer Michael Messerli Dominik C. Benz Catherine Gebhard Christoph Gräni Aju P. Pazhenkottil Philipp A. Kaufmann Tobias A. Fuchs Ronny R. Buechel |
| author_facet | Dimitri Patriki Elia von Felten Adam Bakula Andreas A. Giannopoulos Christel H. Kamani Moritz Schwyzer Michael Messerli Dominik C. Benz Catherine Gebhard Christoph Gräni Aju P. Pazhenkottil Philipp A. Kaufmann Tobias A. Fuchs Ronny R. Buechel |
| author_sort | Dimitri Patriki |
| collection | DOAJ |
| description | Abstract Background Inadequate coronary adenosine response is a potential cause for false negative ischemia testing. Recently, the splenic switch-off (SSO) sign has been identified as a promising tool to ascertain the efficacy of adenosine during vasodilator stress cardiovascular magnetic resonance imaging (CMR). We assessed the value of SSO to predict adenosine response, defined as an increase in myocardial blood flow (MBF) during quantitative stress myocardial perfusion 13 N-ammonia positron emission tomography (PET). Methods We prospectively enrolled 64 patients who underwent simultaneous CMR and PET myocardial perfusion imaging on a hybrid PET/CMR scanner with co-injection of gadolinium based contrast agent (GBCA) and 13N-ammonia during rest and adenosine-induced stress. A myocardial flow reserve (MFR) of > 1.5 or ischemia as assessed by PET were defined as markers for adequate coronary adenosine response. The presence or absence of SSO was visually assessed. The stress-to-rest intensity ratio (SIR) was calculated as the ratio of stress over rest peak signal intensity for splenic tissue. Additionally, the spleen-to-myocardium ratio, defined as the relative change of spleen to myocardial signal, was calculated for stress (SMRstress) and rest. Results Sixty-one (95%) patients were coronary adenosine responders, but SSO was absent in 18 (28%) patients. SIR and SMRstress were significantly lower in patients with SSO (SIR: 0.56 ± 0.13 vs. 0.93 ± 0.23; p < 0.001 and SMRstress: 1.09 ± 0.47 vs. 1.68 ± 0.62; p < 0.001). Mean hyperemic and rest MBF were 2.12 ± 0.68 ml/min/g and 0.78 ± 0.26 ml/min/g, respectively. MFR was significantly higher in patients with vs. patients without presence of SSO (3.07 ± 1.03 vs. 2.48 ± 0.96; p = 0.038), but there was only a weak inverse correlation between SMRstress and MFR (R = -0.378; p = 0.02) as well as between SIR and MFR (R = -0.356; p = 0.004). Conclusions The presence of SSO implies adequate coronary adenosine-induced MBF response. Its absence, however, is not a reliable indicator for failed adenosine-induced coronary vasodilatation. |
| first_indexed | 2025-03-22T04:50:45Z |
| format | Article |
| id | doaj.art-0aad01b51a5e4ab5b610388885d1ec6c |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2025-03-22T04:50:45Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-0aad01b51a5e4ab5b610388885d1ec6c2024-04-27T18:09:37ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2021-01-012311710.1186/s12968-020-00696-ySplenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scannerDimitri Patriki0Elia von Felten1Adam Bakula2Andreas A. Giannopoulos3Christel H. Kamani4Moritz Schwyzer5Michael Messerli6Dominik C. Benz7Catherine Gebhard8Christoph Gräni9Aju P. Pazhenkottil10Philipp A. Kaufmann11Tobias A. Fuchs12Ronny R. Buechel13Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University ZurichAbstract Background Inadequate coronary adenosine response is a potential cause for false negative ischemia testing. Recently, the splenic switch-off (SSO) sign has been identified as a promising tool to ascertain the efficacy of adenosine during vasodilator stress cardiovascular magnetic resonance imaging (CMR). We assessed the value of SSO to predict adenosine response, defined as an increase in myocardial blood flow (MBF) during quantitative stress myocardial perfusion 13 N-ammonia positron emission tomography (PET). Methods We prospectively enrolled 64 patients who underwent simultaneous CMR and PET myocardial perfusion imaging on a hybrid PET/CMR scanner with co-injection of gadolinium based contrast agent (GBCA) and 13N-ammonia during rest and adenosine-induced stress. A myocardial flow reserve (MFR) of > 1.5 or ischemia as assessed by PET were defined as markers for adequate coronary adenosine response. The presence or absence of SSO was visually assessed. The stress-to-rest intensity ratio (SIR) was calculated as the ratio of stress over rest peak signal intensity for splenic tissue. Additionally, the spleen-to-myocardium ratio, defined as the relative change of spleen to myocardial signal, was calculated for stress (SMRstress) and rest. Results Sixty-one (95%) patients were coronary adenosine responders, but SSO was absent in 18 (28%) patients. SIR and SMRstress were significantly lower in patients with SSO (SIR: 0.56 ± 0.13 vs. 0.93 ± 0.23; p < 0.001 and SMRstress: 1.09 ± 0.47 vs. 1.68 ± 0.62; p < 0.001). Mean hyperemic and rest MBF were 2.12 ± 0.68 ml/min/g and 0.78 ± 0.26 ml/min/g, respectively. MFR was significantly higher in patients with vs. patients without presence of SSO (3.07 ± 1.03 vs. 2.48 ± 0.96; p = 0.038), but there was only a weak inverse correlation between SMRstress and MFR (R = -0.378; p = 0.02) as well as between SIR and MFR (R = -0.356; p = 0.004). Conclusions The presence of SSO implies adequate coronary adenosine-induced MBF response. Its absence, however, is not a reliable indicator for failed adenosine-induced coronary vasodilatation.https://doi.org/10.1186/s12968-020-00696-ySplenic switch-offCardiovascular magnetic resonance imagingMyocardial perfusion imaging |
| spellingShingle | Dimitri Patriki Elia von Felten Adam Bakula Andreas A. Giannopoulos Christel H. Kamani Moritz Schwyzer Michael Messerli Dominik C. Benz Catherine Gebhard Christoph Gräni Aju P. Pazhenkottil Philipp A. Kaufmann Tobias A. Fuchs Ronny R. Buechel Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner Journal of Cardiovascular Magnetic Resonance Splenic switch-off Cardiovascular magnetic resonance imaging Myocardial perfusion imaging |
| title | Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner |
| title_full | Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner |
| title_fullStr | Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner |
| title_full_unstemmed | Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner |
| title_short | Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner |
| title_sort | splenic switch off as a predictor for coronary adenosine response validation against 13n ammonia during co injection myocardial perfusion imaging on a hybrid pet cmr scanner |
| topic | Splenic switch-off Cardiovascular magnetic resonance imaging Myocardial perfusion imaging |
| url | https://doi.org/10.1186/s12968-020-00696-y |
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