2024
AI-Defined Cardiac Anatomy Improves Risk Stratification of Hybrid Perfusion Imaging
Miller R, Shanbhag A, Killekar A, Lemley M, Bednarski B, Kavanagh P, Feher A, Miller E, Bateman T, Builoff V, Liang J, Newby D, Dey D, Berman D, Slomka P. AI-Defined Cardiac Anatomy Improves Risk Stratification of Hybrid Perfusion Imaging. JACC Cardiovascular Imaging 2024, 17: 780-791. PMID: 38456877, PMCID: PMC11222053, DOI: 10.1016/j.jcmg.2024.01.006.Peer-Reviewed Original ResearchComputed tomography attenuation correctionMajor adverse cardiovascular eventsCoronary artery calciumLV massMyocardial perfusion imagingPerfusion imagingSingle-photon emission computed tomography/computed tomographyIncreased risk of MACEAssociated with major adverse cardiovascular eventsRisk of Major Adverse Cardiovascular EventsCardiac chamber volumesMedian follow-upCT-based volumesRight ventricular volumesImprove cardiovascular risk assessmentAdverse cardiovascular eventsQuartile of LV massContinuous net reclassification indexCoronary artery diseaseNet reclassification indexCardiovascular risk assessmentTomography/computed tomographyConsecutive patientsImprove risk predictionPrognostic utility
2023
Comparison of the prognostic value between quantification and visual estimation of coronary calcification from attenuation CT in patients undergoing SPECT myocardial perfusion imaging
Feher A, Pieszko K, Shanbhag A, Lemley M, Miller R, Huang C, Miras L, Liu Y, Gerber J, Sinusas A, Miller E, Slomka P. Comparison of the prognostic value between quantification and visual estimation of coronary calcification from attenuation CT in patients undergoing SPECT myocardial perfusion imaging. The International Journal Of Cardiovascular Imaging 2023, 40: 185-193. PMID: 37845406, PMCID: PMC466934, DOI: 10.1007/s10554-023-02980-1.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsCoronary artery calcificationMyocardial perfusion imagingCT myocardial perfusion imagingSPECT/CT myocardial perfusion imagingArtery calcificationPrognostic valuePrior coronary stentingAdverse cardiovascular eventsSimilar prognostic valueSPECT myocardial perfusionREFINE SPECT registrySPECT/CTCardiovascular eventsCAC scoringCalcium scoreCoronary calcificationCoronary stentingPrognostic utilitySingle centerCoronary arteryLow doseMyocardial perfusionPerfusion imagingSurvival analysisTime and event-specific deep learning for personalized risk assessment after cardiac perfusion imaging
Pieszko K, Shanbhag A, Singh A, Hauser M, Miller R, Liang J, Motwani M, Kwieciński J, Sharir T, Einstein A, Fish M, Ruddy T, Kaufmann P, Sinusas A, Miller E, Bateman T, Dorbala S, Di Carli M, Berman D, Dey D, Slomka P. Time and event-specific deep learning for personalized risk assessment after cardiac perfusion imaging. Npj Digital Medicine 2023, 6: 78. PMID: 37127660, PMCID: PMC10151323, DOI: 10.1038/s41746-023-00806-x.Peer-Reviewed Original ResearchAcute coronary syndromeMajor adverse cardiovascular eventsMyocardial perfusion imagingCause deathAdverse cardiovascular eventsModifiable risk factorsPrediction of deathPersonalized risk assessmentCardiovascular eventsCoronary syndromeClinical featuresPrognostic valueRisk factorsExternal cohortStandard clinical interpretationPerfusion imagingAbnormality measuresCardiac perfusionTime pointsPatients' explanationsClinical interpretationExternal validationDeathPatientsRisk assessment
2022
Integration of coronary artery calcium scoring from CT attenuation scans by machine learning improves prediction of adverse cardiovascular events in patients undergoing SPECT/CT myocardial perfusion imaging
Feher A, Pieszko K, Miller R, Lemley M, Shanbhag A, Huang C, Miras L, Liu YH, Sinusas AJ, Miller EJ, Slomka PJ. Integration of coronary artery calcium scoring from CT attenuation scans by machine learning improves prediction of adverse cardiovascular events in patients undergoing SPECT/CT myocardial perfusion imaging. Journal Of Nuclear Cardiology 2022, 30: 590-603. PMID: 36195826, DOI: 10.1007/s12350-022-03099-x.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsMyocardial perfusion imagingAdverse cardiovascular eventsSPECT myocardial perfusion imagingCAC scoringCardiovascular eventsPrediction of MACECoronary artery calcification (CAC) scoringMACE-free survivalClinical risk factorsCoronary artery calciumCT myocardial perfusion imagingReceiver operator characteristic curveSPECT/CT myocardial perfusion imagingSPECT/CTOperator characteristic curveCT myocardial perfusionArtery calciumCAC scoreAnalysis patientsMACE predictionSingle centerHigher event ratesRisk factorsRisk score
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 predictorA phenomapping-derived tool to personalize the selection of anatomical vs. functional testing in evaluating chest pain (ASSIST)
Oikonomou EK, Van Dijk D, Parise H, Suchard MA, de Lemos J, Antoniades C, Velazquez EJ, Miller EJ, Khera R. A phenomapping-derived tool to personalize the selection of anatomical vs. functional testing in evaluating chest pain (ASSIST). European Heart Journal 2021, 42: 2536-2548. PMID: 33881513, PMCID: PMC8488385, DOI: 10.1093/eurheartj/ehab223.Peer-Reviewed Original ResearchConceptsStable chest painChest painPrimary endpointMajor adverse cardiovascular eventsNon-fatal myocardial infarctionAdverse cardiovascular eventsStudy's primary endpointCoronary artery diseaseClinical trial populationsCox regression modelParticipant-level dataSCOT-HEARTCardiovascular eventsCause mortalityHazard ratioPatients 5Artery diseaseFunctional testingPROMISE trialTrial populationMyocardial infarctionLower incidenceStudy populationPainCollected variablesQuantitation of Poststress Change in Ventricular Morphology Improves Risk Stratification
Miller RJH, Sharir T, Otaki Y, Gransar H, Liang JX, 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. Quantitation of Poststress Change in Ventricular Morphology Improves Risk Stratification. Journal Of Nuclear Medicine 2021, 62: 1582-1590. PMID: 33712535, PMCID: PMC8612345, DOI: 10.2967/jnumed.120.260141.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsEccentricity indexIndependent associationMyocardial perfusion
2020
Impact of Early Revascularization on Major Adverse Cardiovascular Events in Relation to Automatically Quantified Ischemia
Azadani PN, Miller RJH, Sharir T, Diniz MA, Hu LH, Otaki Y, Gransar H, Liang JX, Eisenberg E, 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. Impact of Early Revascularization on Major Adverse Cardiovascular Events in Relation to Automatically Quantified Ischemia. JACC Cardiovascular Imaging 2020, 14: 644-653. PMID: 32828784, PMCID: PMC7987223, DOI: 10.1016/j.jcmg.2020.05.039.Peer-Reviewed Original ResearchConceptsIschemic total perfusion deficitTotal perfusion deficitEarly revascularizationSPECT-MPIMajor adverse cardiovascular eventsPropensity scoreMultivariable Cox modelingAdverse cardiovascular eventsSingle-center dataContemporary cardiology practiceSingle photon emissionCardiovascular eventsPrimary outcomeCardiac deathConsecutive patientsCox modelingMulticenter studyPerfusion deficitsInternational registryRevascularizationCardiology practicePatientsIschemiaSignificant associationMACE
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 perfusionPatientsDiabetesTransient 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 deficits