Heart failure & cardiomyopathies
The prognostic interplay between PET-derived resting myocardial blood flow and left ventricular ejection fraction
Authors' conclusion
The prognostic value of MBFrest and MFR is much more apparent at higher EFs, with a high MBFrest (and/or low MFR) identfying patients with a much higher risk than would be predicted based on their EF alone.
Study context
- Population
- Consecutive patients undergoing stress/rest MPI using Rb-82 PET between 2019 and 2024median follow-up 519 days (IQR: 186–916 days)
- Participants
- 8,089 patients
- Comparison
- The 50th percentile of MBFrest/myocardial flow reserve (MFR) served as the reference, with the 25th and 75th percentiles representing low and high comparators respectively
- Outcome
- Composite of:
- Death
- Heart failure (HF) hospitalizations
- Follow-up
- Median 519 days (IQR: 186-916 days)
Methodological detailsMultivariable Andersen-Gill Cox models, Restricted cubic splines
- Multivariable Andersen-Gill Cox models
- Restricted cubic splines
Main finding
As reported in the abstract
Each group vs 50th percentile of MBFrest/MFRHazard ratio (95% CI)
High MBFrest
1.39(1.18–1.63)
Low MFR
1.70(1.41–2.04)
- Deaths
- 466
- Heart failure (HF) hospitalizations
- 819
Further findings
HRs by ejection fraction (EF) (40%, 50%, 60%, 70%)
- High vs. low MBFrest at EFs of 40%, 50%, 60%, 70%
- 1.24, 1.61, 1.97, and 2.46
- Low vs. high MFR at EFs of 40%, 50%, 60%, 70%
- 1.57, 2.06, 2.59, and 3.13
Death or HF hospitalization at constant MFRs
- Across the spectrum of EF, a higher MBFrest carried a greater risk of death or HF hospitalization at constant MFRs
Original publication
The prognostic interplay between PET-derived resting myocardial blood flow and left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging. Published 29 April 2025. doi:10.
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