Key result
APOLLO registry establishes 82Rb-PET/CT cardio-renal perfusion and CKM phenotyping in ~1,200 patients.
Why the study?
The potential of routine cardiac 82 Rb-PET/CT for integrated cardio-renal perfusion assessment and broader cardiovascular-kidney-metabolic (CKM) phenotyping remains underexplored, and real-world registries integrating these phenotypes with clinical outcomes are lacking.
Cohort (n=1,200)
No
This design paper establishes the APOLLO registry to repurpose routine cardiac 82Rb-PET/CT scans for simultaneous quantification of myocardial and renal perfusion alongside CT-derived cardiometabolic biomarkers to study outcomes across the CKM syndrome spectrum.
Answers are grounded in this paper and cite their sources.
Enables integrated cardio-renal phenotyping in CKM patients; leaves open whether perfusion metrics improve risk stratification.
Background Cardiovascular-kidney-metabolic (CKM) syndrome encompasses interconnected diseases that share pathophysiological mechanisms, including microvascular dysfunction. Although rubidium-82 positron emission tomography/computed tomography (²Rb-PET/CT) is routinely used for myocardial perfusion imaging, its potential for integrated cardio-renal perfusion assessment and broader CKM phenotyping remains underexplored. We recently developed a compartment modelling approach to quantify renal perfusion from existing routine cardiac 82 Rb-PET/CT scans, enabling simultaneous assessment of myocardial and kidney perfusion. However, real-world registries integrating these phenotypes with clinical outcomes are lacking. Aim To establish a registry integrating 82 Rb-PET-derived myocardial and renal perfusion, CT-derived CKM imaging biomarkers, and detailed clinical and outcome data. Methods The APOLLO registry is a single-centre, retrospective database comprising approximately 1,200 consecutive patients who underwent myocardial perfusion imaging with 82 Rb-PET/CT at Alrijne Hospital (Leiderdorp, the Netherlands) between 2021-2023. Clinical, laboratory, medication, echocardiographic, and imaging data were retrospectively collected. Myocardial perfusion was quantified using myocardial blood flow and myocardial flow reserve, and renal perfusion using renal blood flow and effective renal plasma flow. Additional CT-derived biomarkers included measures of adiposity and frailty, great vessel diameters, and vascular calcification. Echocardiographic diastolic dysfunction grade, H 2 FPEF score, CKM stage, and major adverse cardiovascular events (MACE) were also collected. Conclusion The APOLLO registry integrates ²Rb-PET-derived myocardial and renal perfusion measurements with CT-derived CKM imaging biomarkers and clinical outcomes. This enables investigation of cardio-renal perfusion and their associations with CKM phenotypes and cardiovascular outcomes.
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Siadari et al. (2026) conducted a cohort in Suspected myocardial ischemia or coronary artery disease (cardiovascular-kidney-metabolic syndrome phenotyping) (n=1,200). Integrated cardio-renal perfusion and CKM phenotyping via routine cardiac 82Rb-PET/CT was evaluated on 5-point composite major adverse cardiovascular events (MACE: cardiovascular death, myocardial infarction, stroke, heart failure hospitalization, and coronary revascularization). The APOLLO registry establishes a cohort of ~1,200 patients integrating 82Rb-PET/CT cardio-renal perfusion, CKM biomarkers, and clinical outcomes.
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