This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Beanlands, R. S. B. Search for Related Content PubMed PubMed Citation Articles by Beanlands, R. S. B.

Positron emission tomography and recovery following revascularization (PARR-1): the importance of scar and the development of a prediction rule for the degree of recovery of left ventricular function

Rob S. B. Beanlands, MD, FACC, FRCP(C)^*,*, Terrence D. Ruddy, MD, FACC, FRCP(C)^*, Robert A. deKemp, PhD^*, Robert M. Iwanochko, MD, FRCP(C), Geoffrey Coates, MD, FRCP(C), Michael Freeman, MD, FACC, FRCP(C), Claude Nahmias, PhD, Paul Hendry, MD, FRCS(C)^*, Robert J. Burns, MD, FACC, FRCP(C), Andre Lamy, MD, FRCP(C), Lynda Mickleborough, MD, FRCP(C), William Kostuk, MD, FACC, FRCP(C)^||, Ernest Fallen, MD, FACC, FRCP(C), Graham Nichol, MD, MPH, FRCP(C)^¶ PARR Investigators

^* Cardiac PET Centre, Divisions of Cardiology and Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
Divisions of Cardiology and Cardiac Surgery, Toronto Hospital Western and General Divisions and St. Michael’s Hospital, University of Toronto Health Sciences Network, Toronto, Ontario, Canada
E. S. Garnett Memorial PET Centre, Department of Radiology, McMaster University and Department of Nuclear Medicine, Hamilton Health Sciences, Hamilton, Ontario, Canada
Divisions of Cardiology and Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
^|| Division of Cardiology, London Health Sciences Centre, London, Ontario, Canada
^¶ Cardiovascular Outcomes Related to Economics Group, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada

View larger version (73K): [in a new window]   Figure 1 Examples of reconstructed polar maps for three patients: A, B, C. In each set, the top panel is the raw perfusion (left) and raw F-18-fluorodeoxyglucose (FDG) uptake (right) polar maps; middle panel is the normalized perfusion and FDG uptake; and the lowest panel is the scar score (left) and mismatch score (right). (A) Predominantly scar in the inferolateral and anteroseptal walls and apex. Of the total left ventricle (LV) myocardium, 53% was normal, 42% was scar, and 5% was mismatch. The model predicted a change in ejection fraction (EF) of 0%; observed change was from 26% to 25% = –1%. (B) Partial mismatch (mixture of scar and hibernating myocardium) in the large defect involving the inferolateral wall and apex extending to the distal anteroseptal wall. Of the total LV myocardium, 62% was normal, 23% was scar, and 15% was mismatch. Model predicted change in EF of 4%; observed change was from 23% to 28% = 5%. (C) Small basal inferior scar is noted: 89% was normal, 9% was scar, and 2% was mismatch. Model predicted change in EF was 15%; observed change was from 23% to 37% = 14%.

View larger version (18K): [in a new window]   Figure 2 Prediction model: observed vs. fitted change in absolute ejection fraction. Correlation coefficient: r = 0.60; p = 0.0003.

View larger version (15K): [in a new window]   Figure 3 Absolute change in ejection fraction (EF) versus scar scores: small (0% to 16% of left ventricle [LV]), moderate (16% to 27.5% of LV), and large (27.5% to 47% of LV); * p = 0.002, small versus large scar score.