2022
Handling missing values in machine learning to predict patient-specific risk of adverse cardiac events: Insights from REFINE SPECT registry
Rios R, Miller RJH, Manral N, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Van Kriekinge SD, Kavanagh PB, Parekh T, Liang JX, Dey D, Berman DS, Slomka PJ. Handling missing values in machine learning to predict patient-specific risk of adverse cardiac events: Insights from REFINE SPECT registry. Computers In Biology And Medicine 2022, 145: 105449. PMID: 35381453, PMCID: PMC9117456, DOI: 10.1016/j.compbiomed.2022.105449.Peer-Reviewed Original ResearchPrevalence and predictors of automatically quantified myocardial ischemia within a multicenter international registry
Han D, Rozanski A, Miller RJH, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Liang JX, Dey D, Berman DS, Slomka PJ. Prevalence and predictors of automatically quantified myocardial ischemia within a multicenter international registry. Journal Of Nuclear Cardiology 2022, 29: 3221-3232. PMID: 35174442, PMCID: PMC9378748, DOI: 10.1007/s12350-021-02829-x.Peer-Reviewed Original ResearchConceptsTotal perfusion deficitMyocardial ischemiaStress testingCAD risk factorsMulticenter international registryPredictor of ischemiaCardiac stress testingNuclear stress testingChi-square testConclusionThe prevalenceMulticenter registryOverall cohortTypical anginaCAD statusPerfusion deficitsInternational registryMale genderRisk factorsLVEFIschemiaPatientsImaging characteristicsPotent predictorPrevalenceRegistry
2021
Comparison of diabetes to other prognostic predictors among patients referred for cardiac stress testing: A contemporary analysis from the REFINE SPECT Registry
Han D, Rozanski A, Gransar H, Tzolos E, Miller RJH, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Liang JX, Hu LH, Dey D, Berman DS, Slomka PJ. Comparison of diabetes to other prognostic predictors among patients referred for cardiac stress testing: A contemporary analysis from the REFINE SPECT Registry. Journal Of Nuclear Cardiology 2021, 29: 3003-3014. PMID: 34757571, PMCID: PMC9085969, DOI: 10.1007/s12350-021-02810-8.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsCoronary artery diseaseTotal perfusion deficitCardiac stress testingStress testingComparison of diabetesAdverse cardiovascular eventsStress test patientsCardiac stress test patientsREFINE SPECT registryDM statusMACE riskBackgroundDiabetes mellitusCardiovascular eventsArtery diseaseVentricular functionPrognostic predictorClinical variablesPerfusion deficitsChi-square analysisSPECT-MPIPatientsTest patientsPropensity scorePotent predictorPrognostic Value of Phase Analysis for Predicting Adverse Cardiac Events Beyond Conventional Single-Photon Emission Computed Tomography Variables: Results From the REFINE SPECT Registry
Kuronuma K, Miller RJH, Otaki Y, Van Kriekinge SD, Diniz MA, Sharir T, Hu LH, Gransar H, Liang JX, Parekh T, Kavanagh PB, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Tamarappoo BK, Dey D, Berman DS, Slomka PJ. Prognostic Value of Phase Analysis for Predicting Adverse Cardiac Events Beyond Conventional Single-Photon Emission Computed Tomography Variables: Results From the REFINE SPECT Registry. Circulation Cardiovascular Imaging 2021, 14: e012386. PMID: 34281372, PMCID: PMC8978932, DOI: 10.1161/circimaging.120.012386.Peer-Reviewed Original ResearchMeSH KeywordsAgedCanadaCoronary CirculationDisease ProgressionFemaleHumansIncidenceIsraelMaleMiddle AgedMyocardial IschemiaMyocardial Perfusion ImagingPredictive Value of TestsPrognosisRegistriesRisk AssessmentRisk FactorsStroke VolumeTomography, Emission-Computed, Single-PhotonUnited StatesVentricular Function, LeftConceptsMajor adverse cardiac eventsVentricular ejection fractionTotal perfusion deficitSingle photon emissionAdverse cardiac eventsEjection fractionPerfusion deficitsCardiac eventsPrognostic valueTomography myocardial perfusion imagingVentricular ejection fraction assessmentHighest decile groupProportional hazards analysisTomography myocardial perfusionIndependent prognostic significanceIndependent prognostic valueLarge multinational registryEjection fraction assessmentMyocardial perfusion imagingREFINE SPECT registryAdditional radiation exposureConventional single-photon emissionMACE riskMACE rateMultinational registryDetermining a minimum set of variables for machine learning cardiovascular event prediction: results from REFINE SPECT registry
Rios R, Miller RJH, Hu LH, Otaki Y, Singh A, Diniz M, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, DiCarli M, Van Kriekinge S, Kavanagh P, Parekh T, Liang JX, Dey D, Berman DS, Slomka P. Determining a minimum set of variables for machine learning cardiovascular event prediction: results from REFINE SPECT registry. Cardiovascular Research 2021, 118: 2152-2164. PMID: 34259870, PMCID: PMC9302886, DOI: 10.1093/cvr/cvab236.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsMyocardial perfusion imagingTotal perfusion deficitPrognostic accuracyREFINE SPECT registryImaging variablesTraditional multivariable modelsMultivariable modelStress total perfusion deficitAdverse cardiac eventsReceiver-operating characteristic curveOptimal risk stratificationTomography (SPECT) MPIComparable prognostic accuracyComparable prognostic performanceHigher prognostic accuracySingle photon emissionCardiovascular event predictionCardiac eventsRisk stratificationClinical variablesPerfusion deficitsPrognostic performancePerfusion imagingCollected variables
2020
Automated quantitative analysis of CZT SPECT stratifies cardiovascular risk in the obese population: Analysis of the REFINE SPECT registry
Klein E, Miller RJH, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Otaki Y, Gransar H, Liang JX, Dey D, Berman DS, Slomka PJ. Automated quantitative analysis of CZT SPECT stratifies cardiovascular risk in the obese population: Analysis of the REFINE SPECT registry. Journal Of Nuclear Cardiology 2020, 29: 727-736. PMID: 32929639, PMCID: PMC8497048, DOI: 10.1007/s12350-020-02334-7.Peer-Reviewed Original ResearchConceptsBody mass indexTotal perfusion deficitStress total perfusion deficitMyocardial perfusion imagingSPECT myocardial perfusion imagingPrognostic accuracyObese populationMajor adverse cardiac event risksCox proportional hazards analysisDifferent obesity categoriesRobust risk stratificationCardiac event riskProportional hazards analysisHigher prognostic accuracyREFINE SPECT registrySoft tissue attenuationQuantitative perfusion analysisMACE riskObesity categoriesCardiovascular riskObese patientsAdjusted analysisMass indexRisk stratificationSignificant obesitySurvival Following Implantable Cardioverter‐Defibrillator Implantation in Patients With Amyloid Cardiomyopathy
Higgins AY, Annapureddy AR, Wang Y, Minges KE, Lampert R, Rosenfeld LE, Jacoby DL, Curtis JP, Miller EJ, Freeman JV. Survival Following Implantable Cardioverter‐Defibrillator Implantation in Patients With Amyloid Cardiomyopathy. Journal Of The American Heart Association 2020, 9: e016038. PMID: 32867553, PMCID: PMC7726970, DOI: 10.1161/jaha.120.016038.Peer-Reviewed Original ResearchConceptsImplantable cardioverter defibrillator implantationCardioverter-defibrillator implantationNonischemic cardiomyopathyCardiac amyloidosisDiabetes mellitusCerebrovascular diseaseVentricular tachycardiaMultivariable Cox proportional hazards regression modelsCox proportional hazards regression modelProportional hazards regression modelsKaplan-Meier survival curvesCox proportional hazards modelPropensity-matched cohortOutcomes of patientsHazards regression modelsProportional hazards modelCause mortalityICD implantationRenal functionMultivariable analysisConclusions MortalityRisk factorsRegistry dataAmyloid cardiomyopathyHigh risk
2019
Myocardial Ischemic Burden and Differences in Prognosis Among Patients With and Without Diabetes: Results From the Multicenter International REFINE SPECT Registry
Han D, Rozanski A, Gransar H, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Liang JX, Hu LH, Germano G, Dey D, Berman DS, Slomka PJ. Myocardial Ischemic Burden and Differences in Prognosis Among Patients With and Without Diabetes: Results From the Multicenter International REFINE SPECT Registry. Diabetes Care 2019, 43: 453-459. PMID: 31776140, PMCID: PMC6971784, DOI: 10.2337/dc19-1360.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngina, UnstableCohort StudiesCoronary Artery DiseaseDiabetes MellitusDiabetic AngiopathiesFemaleHumansMaleMiddle AgedMyocardial InfarctionMyocardial IschemiaMyocardial Perfusion ImagingPrevalencePrognosisPropensity ScoreRegistriesRisk FactorsTomography, Emission-Computed, Single-PhotonConceptsMajor adverse cardiovascular eventsTotal perfusion deficitMACE riskMyocardial ischemic burdenAdverse cardiovascular eventsTomography myocardial perfusionREFINE SPECT registrySingle photon emissionIschemic burdenMinimal ischemiaCardiovascular eventsCause mortalityLate revascularizationPrognostic impactUnstable anginaSignificant ischemiaPerfusion deficitsMyocardial infarctionMyocardial ischemiaRisk factorsCardiovascular diseaseHigh riskMyocardial perfusionPatientsDiabetesMachine learning predicts per-vessel early coronary revascularization after fast myocardial perfusion SPECT: results from multicentre REFINE SPECT registry.
Hu LH, Betancur J, Sharir T, Einstein AJ, Bokhari S, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Germano G, Commandeur F, Liang JX, Otaki Y, Tamarappoo BK, Dey D, Berman DS, Slomka PJ. Machine learning predicts per-vessel early coronary revascularization after fast myocardial perfusion SPECT: results from multicentre REFINE SPECT registry. European Heart Journal - Cardiovascular Imaging 2019, 21: 549-559. PMID: 31317178, PMCID: PMC7167744, DOI: 10.1093/ehjci/jez177.Peer-Reviewed Original ResearchConceptsEarly coronary revascularizationMyocardial perfusion imagingStress TPDCoronary revascularizationTomography myocardial perfusion imagingTetrofosmin myocardial perfusion imagingSPECT myocardial perfusion imagingInvasive coronary angiographyReceiver operator characteristic curveREFINE SPECT registryPatient-specific explanationsOperator characteristic curveSingle photon emissionMyocardial perfusion SPECTCoronary angiographyIndividual patientsImaging variablesPatientsPerfusion SPECTPerfusion imagingClinical settingCharacteristic curveRevascularizationExpert interpretationStress testTransient ischaemic dilation and post-stress wall motion abnormality increase risk in patients with less than moderate ischaemia: analysis of the REFINE SPECT registry.
Miller RJH, Hu LH, Gransar H, Betancur J, Eisenberg E, Otaki Y, Sharir T, Fish MB, Ruddy TD, Dorbala S, Carli MD, Einstein AJ, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman T, Germano G, Tamarappoo BK, Dey D, Berman DS, Slomka PJ. Transient ischaemic dilation and post-stress wall motion abnormality increase risk in patients with less than moderate ischaemia: analysis of the REFINE SPECT registry. European Heart Journal - Cardiovascular Imaging 2019, 21: 567-575. PMID: 31302679, PMCID: PMC7167750, DOI: 10.1093/ehjci/jez172.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsTransient ischemic dilationWall motion abnormalitiesModerate ischaemiaMyocardial perfusion imagingMild ischaemiaIschemic dilationMultivariable Cox proportional hazards analysisHigh-risk imaging featuresCox proportional hazards analysisTomography myocardial perfusion imagingAdverse cardiovascular eventsHigh-risk featuresGroup of patientsProportional hazards analysisIncremental prognostic utilityTotal perfusion deficitREFINE SPECT registrySingle photon emissionMedian followCardiovascular eventsCardiovascular riskMultivariable analysisPrognostic utilityPerfusion deficits5-Year Prognostic Value of Quantitative Versus Visual MPI in Subtle Perfusion Defects Results From REFINE SPECT
Otaki Y, Betancur J, Sharir T, Hu LH, Gransar H, Liang JX, Azadani PN, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Tamarappoo BK, Germano G, Dey D, Berman DS, Slomka PJ. 5-Year Prognostic Value of Quantitative Versus Visual MPI in Subtle Perfusion Defects Results From REFINE SPECT. JACC Cardiovascular Imaging 2019, 13: 774-785. PMID: 31202740, PMCID: PMC6899217, DOI: 10.1016/j.jcmg.2019.02.028.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsTotal perfusion deficitStress total perfusion deficitMACE rateHazard ratioRate of MACECox proportional hazards analysisTomography myocardial perfusion imagingAdjusted hazard ratioAdverse cardiac eventsNonfatal myocardial infarctionProportional hazards analysisMyocardial perfusion imagingSingle photon emissionCardiac eventsLate revascularizationUnstable anginaRisk stratificationPrognostic valueKaplan-MeierPerfusion abnormalitiesPerfusion deficitsMyocardial infarctionPrognostic studiesMyocardial perfusionUpper reference limits of transient ischemic dilation ratio for different protocols on new-generation cadmium zinc telluride cameras: A report from REFINE SPECT registry
Hu LH, Sharir T, Miller RJH, Einstein AJ, Fish MB, Ruddy TD, Dorbala S, Di Carli M, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Betancur J, Germano G, Liang JX, Commandeur F, Azadani PN, Gransar H, Otaki Y, Tamarappoo BK, Dey D, Berman DS, Slomka PJ. Upper reference limits of transient ischemic dilation ratio for different protocols on new-generation cadmium zinc telluride cameras: A report from REFINE SPECT registry. Journal Of Nuclear Cardiology 2019, 27: 1180-1189. PMID: 31087268, PMCID: PMC6851400, DOI: 10.1007/s12350-019-01730-y.Peer-Reviewed Original ResearchConceptsTransient ischemic dilationUpper reference limitReference limitsMulticenter registrySupine positionTransient ischemic dilation ratioCoronary artery diseaseCadmium zinc telluride cameraQuantitative perfusion SPECT softwareREFINE SPECT registryIschemic dilationArtery diseasePerfusion findingsMyocardial perfusionD-SPECTRegistryLower likelihoodSPECT softwareTelluride cameraRadiotracerDilation ratioDifferent protocolsPatientsPerfusionDisease
2018
Rationale and design of the REgistry of Fast Myocardial Perfusion Imaging with NExt generation SPECT (REFINE SPECT)
Slomka PJ, Betancur J, Liang JX, Otaki Y, Hu LH, Sharir T, Dorbala S, Di Carli M, Fish MB, Ruddy TD, Bateman TM, Einstein AJ, Kaufmann PA, Miller EJ, Sinusas AJ, Azadani PN, Gransar H, Tamarappoo BK, Dey D, Berman DS, Germano G. Rationale and design of the REgistry of Fast Myocardial Perfusion Imaging with NExt generation SPECT (REFINE SPECT). Journal Of Nuclear Cardiology 2018, 27: 1010-1021. PMID: 29923104, PMCID: PMC6301135, DOI: 10.1007/s12350-018-1326-4.Peer-Reviewed Original ResearchMeSH KeywordsAgedArtificial IntelligenceAutomationCoronary AngiographyCoronary Artery DiseaseData CollectionDatabases, FactualFemaleFollow-Up StudiesHumansImage Processing, Computer-AssistedMachine LearningMaleMiddle AgedMyocardial Perfusion ImagingPrognosisRegistriesReproducibility of ResultsSoftwareTomography, Emission-Computed, Single-PhotonConceptsMyocardial perfusion imagingPharmacologic stressMajor adverse cardiac eventsAdverse cardiac eventsRevascularization resultsMulticenter registryCardiac eventsClinical variablesPrognostic outcomesResultsTo dateClinical dataPrognostic dataDiagnostic cohortSPECT-MPIImaging variablesMyocardial perfusionPrognostic cohortPerfusion imagingPatientsRegistryArtificial intelligence toolsNew artificial intelligence toolsQuantitative softwareCohortClinical image databaseDeep Learning for Prediction of Obstructive Disease From Fast Myocardial Perfusion SPECT A Multicenter Study
Betancur J, Commandeur F, Motlagh M, Sharir T, Einstein AJ, Bokhari S, Fish MB, Ruddy TD, Kaufmann P, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Germano G, Otaki Y, Tamarappoo BK, Dey D, Berman DS, Slomka PJ. Deep Learning for Prediction of Obstructive Disease From Fast Myocardial Perfusion SPECT A Multicenter Study. JACC Cardiovascular Imaging 2018, 11: 1654-1663. PMID: 29550305, PMCID: PMC6135711, DOI: 10.1016/j.jcmg.2018.01.020.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCoronary CirculationCoronary StenosisDeep LearningFemaleHumansImage Interpretation, Computer-AssistedMaleMiddle AgedMyocardial Perfusion ImagingOrganophosphorus CompoundsOrganotechnetium CompoundsPredictive Value of TestsRadiopharmaceuticalsRegistriesTechnetium Tc 99m SestamibiTomography, Emission-Computed, Single-PhotonConceptsTotal perfusion deficitMyocardial perfusion imagingCoronary artery diseaseObstructive diseaseArtery diseaseVessel coronary artery diseaseTomography myocardial perfusion imagingTetrofosmin myocardial perfusion imagingLarge multicenter populationStress total perfusion deficitReceiver-operating characteristic curveInvasive coronary angiographyLeft ventricular myocardiumSingle photon emissionMyocardial perfusion SPECTMonths of MPIMulticenter populationObstructive stenosisCoronary angiographyMulticenter studyCoronary arteryPerfusion deficitsNormal limitsVessel sensitivityCurrent clinical methods