Prognostic value of left ventricular hypertrophy assessed with 15O-water positron emission tomography

Figures

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  Figure 1. 15O-water perfusable tissue fraction (PTF) images reoriented to cardiac short axis (upper panel) and horizontal long axis (lower panel) views showing patients with different cardiac geometry. Colour scale maximum is PTF = 1.0. (A) Male patient with normal PET findings and no known left ventricular hypertrophy. (B) Female patient with dilated cardiomyopathy. (C) male patient with cardiac amyloidosis and left ventricular hypertrophy confirmed by echocardiography. WT, interventricular septal wall thickness; LVMi, left ventricular mass index.

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  Figure 2. Boxplots showing the distribution of left ventricular mass index (LVMi) (A) and interventricular septal wall thickness (WT) (B) in patients without heart failure or hypertrophic/infiltrative cardiomyopathy, in heart failure patients, and in patients with hypertrophic/infiltrative cardiomyopathy. Boxes represent the interquartile range (IQR) with median values indicated, whiskers denote values within 1.5 × IQR, and individual data points are shown. Overall group differences were assessed using the Kruskal–Wallis test, with pairwise post-hoc comparisons performed with Wilcoxon rank-sum test and Benjamini–Hochberg correction for multiple testing. Statistical significance in the post-hoc tests is indicated by asterisks (*P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001).

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  Figure 3. Kaplan–Meier survival analysis of left ventricular mass index (LVMi) (A) and interventricular septal wall thickness (WT) (B). Outcome was time to major adverse cardiac event (MACE) defined as a composite of acute heart failure or cardiovascular death. Patients with known heart failure and/or hypertrophic or infiltrative cardiomyopathy were excluded. Blue lines represent patients with low- or normal values and red lines represent left ventricular hypertrophy. Cut-offs were derived from the literature utilizing upper normal values from cardiovascular magnetic resonance imaging (LVMi) and echocardiography (WT). Sex-specific hypertrophy cut-offs were LVMi >65 g/m2 (female) and >83 g/m2 (male), and WT >10 mm (female) and >11 mm (male).

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  Figure 4. Test–retest of positron emission tomography left ventricular mass index (LVMi) and interventricular septal wall thickness (WT) in n = 21 patients. Dashed lines are lines of identity (A, C), dotted lines represent Bland–Altman 95% limits of agreement (B, D), and solid lines represent bias (B, D).