Downward myocardial creep during stress PET imaging is inversely associated with mortality

Figures

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  Fig. 1. Case example of early dynamic images before (A-C) and after (D-F) automated motion correction in patient with significant downward creep at stress. The LV contours before motion correction were automatically positioned from the static imaging. Before correction, the inferior LV contour overlaps substantially with the activity of the LV blood pool, and the anterior LV contour is far from the actual LV myocardium (blue arrows). Those were corrected after automated motion correction (orange arrows). HLA, horizontal long axis; LV, left ventricle; SAX, short axis; VLA, vertical long axis

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  Fig. 2. Annualized mortality rate adjusted by age and sex and deciles of downward creep. The left y axis and blue bars indicate the adjusted annual mortality rates (%). The right y axis and pink line indicate median downward creep (mm)

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  Fig. 3. Kaplan-Meier curves stratified by median downward creep adjusted by following variables: age, sex, body mass index, hypertension, hyperlipidemia, diabetes, smoking, prior history of coronary artery disease, cerebral stroke, peripheral vascular disease, anginal chest pain, shortness of breath, early revascularization, stress TPD, rest TPD, stress-rest change in LVEF, rest LVEF, rest LVEDV, heart rate response, systolic BP response, diastolic BP response, and myocardial flow reserve. BP, blood pressure; LVEDV, left ventricular end-diastolic volume; LVEF, left ventricular ejection fraction; TPD, total perfusion deficit

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  Fig. 4. Forest plot of multivariable adjusted HRs for ACM. Blue bars indicate the variables are significantly and negatively associated with ACM. Red bars indicate the variables are significantly and positively associated with ACM. Black bars indicate the variables are not significantly associated with ACM. ACM, all-cause mortality; BMI, body mass index; BP, blood pressure; CAD, coronary artery disease; HR, hazard ratio; LVEDV, left ventricular end-diastolic volume; LVEF, left ventricular ejection fraction; MFR, myocardial flow reserve; PVD, peripheral vascular disease; TPD, total perfusion deficit

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  Fig. 5. Incremental value of downward creep to predict mortality beyond conventional MPI variables and MFR. MFR, myocardial flow reserve; MPI, myocardial perfusion image