Guiding early revascularization using [15O]H2O positron emission tomography myocardial perfusion imaging: impact of atrial fibrillation
Authors' conclusion
Ongoing AF is associated with 19-25% reduced global hyperaemic MBF as measured by [15O]H2O MPI PET. Regardless, vessel-specific hyperaemic MBF still predicts early revascularization in patients with AF.
Study context
- Population
- Patients with angina and persistent or paroxysmal atrial fibrillation (AF) referred for baseline/hyperaemic [15O]H2O positron emission tomography (PET) myocardial perfusion imaging (MPI)
- Participants
- 346 patients
- Exposure
- Ongoing AF vs sinus rhythm (SR), with and without prior coronary artery disease (CAD)
- Outcome
- Revascularization
- Follow-up
- Within 3 months of MPI
Main finding
As reported in the abstract
Prediction of early revascularization by vessel-specific hyperaemic MBF (AUC)
| Group | AUC |
|---|---|
| SR-noCAD | 0.95 (P < 0.0001) |
| AF-noCAD | 0.79 (P < 0.0001) |
| SR-CAD | 0.78 (P < 0.0001) |
| AF-CAD | 0.88 (P < 0.0001) |
AUC
SR-noCAD0.95 (P < 0.0001)
AF-noCAD0.79 (P < 0.0001)
SR-CAD0.78 (P < 0.0001)
AF-CAD0.88 (P < 0.0001)
- Every 0.1 mL/min/g decrease in hyperaemic myocardial blood flow (MBF) associated with increase in odds of early revascularization
- 23%
Observational data: associations, not effects.
Further findings
Global hyperaemic MBF
- Global hyperaemic MBF — Hyperaemic MBF affected by both ongoing AF and prior CAD (two-way ANOVA)
- P < 0.0001
Global hyperaemic MBF
- Ongoing AF independently associated with reduced hyperaemic MBF (multiple linear regression)
Original publication
Guiding early revascularization using [15O]H2O positron emission tomography myocardial perfusion imaging: impact of atrial fibrillation. Eur Heart J Cardiovasc Imaging. Published 20 February 2024. doi:10.
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