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Papers by David Glover

Bis(N-ethoxy,N-ethyldithiocarbamato)nitrido technetium (V) (99m Tc) (99m TcN-NOET) is a myocardia... more Bis(N-ethoxy,N-ethyldithiocarbamato)nitrido technetium (V) (99m Tc) (99m TcN-NOET) is a myocardial perfusion imaging agent demonstrating significant redistribution and currently in phase III clinical trials. Previous studies have suggested that 99m TcN-NOET is bound intravascularly. Therefore, we sought to determine whether modifications in the vascular compartment would provide further insights into the mechanisms of 99m TcN-NOET myocardial washout and redistribution. Methods: 99m TcN-NOET cardiac washout was studied ex vivo in 15 isolated perfused rat hearts after bolus injection (1.5 MBq) in the absence (n ϭ 6) or presence of bovine serum albumin ([BSA] 0.03%) with (n ϭ 5) or without (n ϭ 4) bound lipids. The intrinsic myocardial washout of the tracer was also studied in vivo in 6 dogs after intracoronary bolus injection of the tracer (0.75 MBq) before and after hyperlipidemia induced by intravenous administration of 300 mL of 20% intralipids (n ϭ 3) or hyperemia induced by intravenous infusion of the adenosine A 2A receptor agonist ATL-146e (0.3 g/kg/min; n ϭ 6). Results: On isolated hearts, there was no significant myocardial washout of 99m TcN-NOET with Krebs-Henseleit buffer. Addition of BSA without bound lipids resulted in a significant cardiac washout of the tracer (P Ͻ 0.001 by repeated measures ANOVA). The presence of lipids bound to BSA further accelerated the washout rate of 99m TcN-NOET (half-life [t 1/2 ], 431.5 Ϯ 23.2 min vs. 242.9 Ϯ 63.2 min; P Ͻ 0.05). In vivo in dogs, intralipid administration significantly increased the intrinsic washout rate of 99m TcN-NOET (t 1/2 , 108.0 Ϯ 23.9 min vs. 51.8 Ϯ 11.8 min; P Ͻ 0.05). In addition, vasodilatation with ATL-146e resulted in a 4.9-fold increase in coronary flow (P Ͻ 0.05 vs. baseline) and a significantly faster intrinsic 99m TcN-NOET myocardial washout (t 1/2 , 81.1 Ϯ 12.1 min vs. 40.7 Ϯ 7.3 min; P Ͻ 0.05). Conclusion: The myocardial washout kinetics of 99m TcN-NOET are affected by a variety of intravascular factors, supporting the hypothesis that the tracer is most likely localized on the vascular endothelium. The potential impact of variations in circulating lipid levels among patients on clinical imaging with 99m TcN-NOET requires further investigation.

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99mTc-[bis (dimethoxypropylphosphinoethyl)-ethoxyethylamine (PNP5)]-[bis (N-ethoxyethyl)-dithioca... more 99mTc-[bis (dimethoxypropylphosphinoethyl)-ethoxyethylamine (PNP5)]-[bis (N-ethoxyethyl)-dithiocarbamato (DBODC)] nitride (N-PNP5-DBODC or N-DBODC5) is a new monocationic myocardial perfusion tracer. We sought to compare the myocardial uptake and clearance kinetics and organ biodistribution of 99mTc-N-DBODC5 with 99mTc-sestamibi and 99mTc-tetrofosmin. Methods: Seventy-five anesthetized Sprague–Dawley rats were injected intravenously with 22.2–29.6 MBq 99mTc-N-DBODC5 (n 25), 99mTc-sestamibi (n 25), or 99mTc-tetrofosmin (n 25). Rats were euthanized at either 2, 10, 20, 30, or 60 min after injection and -well counting was performed on excised organ (heart, lung, and liver) and blood samples. In 3 additional rats, serial in vivo whole-body -camera imaging with each tracer was performed. Results: 99mTc-N-DBODC5 cleared rapidly from the blood pool. At 2 min after injection, 99mTc-N-DBODC5 blood activity was significantly lower than either 99mTc-sestamibi or 99mTc-tetrofosmin (P 0.01) and ...

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2004

Microthromboemboli (MTE) may contribute to the no-reflow phenomenon in acute myocardial infarctio... more Microthromboemboli (MTE) may contribute to the no-reflow phenomenon in acute myocardial infarction (AMI) either spontaneously or after primary percutaneous transluminal coronary angioplasty (PTCA). We hypothesized that myocardial MTE in acute coronary syndromes can be identified on imaging by in vivo (99m)Tc labeling of the coronary thrombus with a compound that binds to the glycoprotein IIb/IIIa present on activated platelets (DMP-444). Fifteen dogs underwent left anterior descending coronary artery (LAD) injury in to produce thrombus, whereas 5 control dogs had LAD ligation. Before recanalization, the risk area (RA) and myocardial blood flow (MBF) were measured, and in vivo thrombus labeling was performed using (99m)Tc-labeled DMP-444. Nine of the 15 LAD injury dogs had occlusive thrombus on angiography and underwent PTCA. MBF measurements were repeated 30 and 60 min after recanalization, and (99m)Tc autoradiography (hot spot imaging) was performed ex vivo to determine the extent ...

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2003

Bis(N-ethoxy,N-ethyldithiocarbamato)nitrido technetium (V) ((99m)Tc) ((99m)TcN-NOET) is a myocard... more Bis(N-ethoxy,N-ethyldithiocarbamato)nitrido technetium (V) ((99m)Tc) ((99m)TcN-NOET) is a myocardial perfusion imaging agent demonstrating significant redistribution and currently in phase III clinical trials. Previous studies have suggested that (99m)TcN-NOET is bound intravascularly. Therefore, we sought to determine whether modifications in the vascular compartment would provide further insights into the mechanisms of (99m)TcN-NOET myocardial washout and redistribution. (99m)TcN-NOET cardiac washout was studied ex vivo in 15 isolated perfused rat hearts after bolus injection (1.5 MBq) in the absence (n = 6) or presence of bovine serum albumin ([BSA] 0.03%) with (n = 5) or without (n = 4) bound lipids. The intrinsic myocardial washout of the tracer was also studied in vivo in 6 dogs after intracoronary bolus injection of the tracer (0.75 MBq) before and after hyperlipidemia induced by intravenous administration of 300 mL of 20% intralipids (n = 3) or hyperemia induced by intraveno...

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2002

Having previously shown that dobutamine reduces (99m)Tc-methoxyisobutylisonitrile (sestamibi [MIB... more Having previously shown that dobutamine reduces (99m)Tc-methoxyisobutylisonitrile (sestamibi [MIBI]) uptake in normal myocardium by elevating intracellular calcium, we hypothesized that arbutamine, which has less inotropic effect than dobutamine, might cause less reduction in MIBI uptake, thereby improving defect contrast. In this study using a canine model, we compared the effects of arbutamine stress on myocardial blood flow, myocardial MIBI uptake, and systolic thickening in the presence of a coronary artery stenosis. Arbutamine was infused (0.5-250 ng/kg/min) in 8 open-chest dogs with critical coronary stenoses that abolished flow reserve. At the time of peak arbutamine effect, MIBI (296 MBq), (201)Tl (27.75 MBq), and microspheres were coinjected. The dogs were killed 5 min later, and myocardial tracer activities and flow were quantified by well counting. Ex vivo imaging of heart slices was also performed. Arbutamine increased mean heart rate, peak positive left ventricular pres...

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2001

Reperfusion is often incomplete after recanalization therapy because of the presence of residual ... more Reperfusion is often incomplete after recanalization therapy because of the presence of residual coronary stenoses. Detecting mild to moderate stenoses requires assessing coronary flow reserve with vasodilator stress. 99mTc-(N-ethoxy-N-ethyl-dithiocarbamato)nitrido (N-NOET) is a viability-independent flow tracer and thus may be well suited for assessing coronary flow reserve in the acute phase of reperfusion. Twelve open-chest dogs underwent 60 min of total left anterior descending artery (LAD) occlusion followed by either full reperfusion (group 1; n = 4) or reperfusion through a residual critical stenosis (group 2; n = 8). 99mTc-N-NOET was given during peak vasodilator stress 165 min after reperfusion, and initial and 60-min delayed images were acquired. Regional blood flow was assessed with radiolabeled microspheres. Infarct size was similar in both groups (9% +/- 2% vs. 8% +/- 2% of left ventricle). Both initial (0.61 +/- 0.02 vs. 0.73 +/- 0.01; P < 0.01) and 60-min (0.67 +/-...

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1995

Experimental studies have shown 99mTc-teboroxime to have a higher first-pass myocardial extractio... more Experimental studies have shown 99mTc-teboroxime to have a higher first-pass myocardial extraction, exceeding that of 201Tl with nearly linear initial myocardial uptake over a wide range of coronary flows. The goal of this study was to quantitatively compare teboroxime with 201Tl for the assessment of a regional coronary flow imbalance when administered during adenosine vasodilation in dogs with either critical or mild LAD stenoses. Twenty-four anesthetized dogs with either critical (n = 10) or mild (n = 14) LAD stenoses were given an i.v. infusion of adenosine (300 micrograms/kg/min). When LCx flow was maximal, 201Tl, teboroxime and microspheres were simultaneously injected and the dogs were killed either 2 or 4 min later. Regional 201Tl, teboroxime activities and myocardial blood flow were determined by gamma well counting and ex vivo imaging of 99mTc-teboroxime activity in myocardial heart slices was performed. In both the critical and mild stenosis groups, the LAD/LCx zone ratio...

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1995

N6-endonorboman-2-yl-9-methyladenine (N-0861) is a drug which inhibits the A1 adenosine receptor ... more N6-endonorboman-2-yl-9-methyladenine (N-0861) is a drug which inhibits the A1 adenosine receptor subtype. One proposed use for N-0861 is to eliminate A1 receptor-mediated side effects such as A-V heart block and possibly angina in patients undergoing pharmacologic stress with adenosine. The goal of this study was to determine whether N-0861 has any crossover effect on the A2 vasodilatory action of adenosine or on 201TI uptake which would adversely affect imaging of coronary stenoses. In eight dogs with critical left anterior descending (LAD) stenoses, we compared the hemodynamic response to intravenous adenosine (250 micrograms/kg/min) before and after N-0861 administration. LAD and left circumflex (LCx) coronary flows were measured ultrasonically and regional blood flow was assessed using microspheres. Thallium-201 (18.5-37.0 MBq) was injected during adenosine hyperemia while N-0861 was present. Imaging of heart slices was performed and defect magnitude was calculated as LAD:LCx co...

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2004

99m Tc-[bis (dimethoxypropylphosphinoethyl)-ethoxyethylamine (PNP5)]-[bis (N-ethoxyethyl)-dithioc... more 99m Tc-[bis (dimethoxypropylphosphinoethyl)-ethoxyethylamine (PNP5)]-[bis (N-ethoxyethyl)-dithiocarbamato (DBODC)] nitride (N-PNP5-DBODC or N-DBODC5) is a new monocationic myocardial perfusion tracer. We sought to compare the myocardial uptake and clearance kinetics and organ biodistribution of 99m Tc-N-DBODC5 with 99m Tc-sestamibi and 99m Tc-tetrofosmin. Methods: Seventy-five anesthetized Sprague-Dawley rats were injected intravenously with 22.2-29.6 MBq 99m Tc-N-DBODC5 (n ϭ 25), 99m Tc-sestamibi (n ϭ 25), or 99m Tc-tetrofosmin (n ϭ 25). Rats were euthanized at either 2, 10, 20, 30, or 60 min after injection and ␥-well counting was performed on excised organ (heart, lung, and liver) and blood samples. In 3 additional rats, serial in vivo whole-body ␥-camera imaging with each tracer was performed. Results: 99m Tc-N-DBODC5 cleared rapidly from the blood pool. At 2 min after injection, 99m Tc-N-DBODC5 blood activity was significantly lower than either 99m Tc-sestamibi or 99m Tc-tetrofosmin (P Ͻ 0.01) and remained lower over 60 min. Myocardial 99m Tc-N-DBODC5 uptake was rapid (2.9% Ϯ 0.1% injected dose/g at 2 min), and there was no significant clearance over 60 min, similar to 99m Tc-sestamibi and 99m Tc-tetrofosmin. All 3 tracers exhibited rapid lung clearance. Importantly, 99m Tc-N-DBODC5 cleared more rapidly from the liver than either 99m Tc-sestamibi or 99m Tc-tetrofosmin. As early as 30 min after injection, 99m Tc-N-DBODC5 heart-to-liver ratio was 5.7 Ϯ 1.0 versus 1.6 Ϯ 0.1 and 2.9 Ϯ 0.3 for 99m Tc-sestamibi and 99m Tctetrofosmin (P Ͻ 0.05). By 60 min, 99m Tc-N-DBODC5 heart-toliver ratio further increased to 18.4 Ϯ 2.0 compared with 2.6 Ϯ 0.2 and 5.8 Ϯ 0.7 for 99m Tc-sestamibi and 99m Tc-tetrofosmin (P Ͻ 0.001). The rapid blood pool, lung, and liver clearance of 99m Tc-N-DBODC5 resulted in excellent-quality myocardial images within 30 min after injection. Conclusion: 99m Tc-N-DBODC5 is a promising new myocardial perfusion tracer with superior biodistribution properties. The rapid 99m Tc-N-DBODC5 liver clearance may shorten the duration of imaging protocols by allowing earlier image acquisition and may markedly reduce the problem of photon scatter from the liver into the inferoapical wall on myocardial images.

Regional distribution of diffusible tracers and carbonized microspheres in the left ventricle of ... more Regional distribution of diffusible tracers and carbonized microspheres in the left ventricle of isolated dog hearts. Circ Res 1973;33:573â€"587. 3 1. Goresky CA, Bach GG, Nadeau BE. Red cell carriage of label: its limiting effect on the exchange of materials in the liver. Circ Res 1975;36:328â€"351. 32. Bergmann SR. Hack SN, Sobel BE. â€oeRedistributionâ€• of myocardial thallium-20l without reperfusion: Implications regarding absolute quantification of perfusion. Am J Cardioll982;49:169l-1698. 33. Weich HF, Strauss 1-lW, Pitt B. The extraction of thallium-201 by the myocardium.

Journal of the American College of Cardiology, 2003

Journal of the American College of Cardiology, 2000

We sought to determine whether the inotropic response to dobutamine might be useful for estimatin... more We sought to determine whether the inotropic response to dobutamine might be useful for estimating the extent of viable myocardium soon after reperfusion. BACKGROUND Early identification of viable myocardium in the presence of severe left ventricular dysfunction after reperfusion is important for clinical decision making. METHODS Nine open-chest dogs had left anterior descending coronary artery occlusion for 40 to 180 min, followed by gradual reperfusion. The systolic thickening response to incremental dobutamine doses was measured with ultrasonic crystals and regional flow by microspheres. RESULTS Dogs were divided into two groups based on triphenyl tetralozium chloride infarct size (group 1: 9.3 Ϯ 3.0% risk area; group 2: 51.1 Ϯ 4.8%). In group 2 dogs with larger infarcts, regional flow during peak dobutamine was lower than it was in group 1 in endocardial (1.15 Ϯ 0.22 vs. 2.64 Ϯ 0.33 mL⅐min Ϫ1 ⅐g Ϫ1) and midwall (1.47 Ϯ 0.32 vs. 2.92 Ϯ 0.36 mL⅐min Ϫ1 ⅐g Ϫ1) layers, and endocardial flow in group 2 failed to increase from baseline (0.96 Ϯ 0.07 vs. 1.15 Ϯ 0.22 mL⅐min Ϫ1 ⅐g Ϫ1). Group 1 dogs demonstrated a dose dependent increase in systolic thickening with dobutamine versus a blunted response in group 2. The inotropic response to only 10 g⅐kg Ϫ1 ⅐min Ϫ1 of dobutamine was predictive of the degree of myocardial salvage. CONCLUSIONS In the early postischemic stunning phase of reperfusion, the inotropic response to dobutamine is predictive of the degree of myocardial salvage and ultimate infarct size. The ability to distinguish between stunned versus necrotic myocardium early after reperfusion was most likely due to the presence of subendocardial flow reserve during dobutamine in dogs with predominantly salvaged myocardium.

Journal of the American College of Cardiology, 1995

may be an important contributor to improved peak aerobic capacity. Thus, low level training produ... more may be an important contributor to improved peak aerobic capacity. Thus, low level training produces benefits similar to high level training with only a moderate rise in PCWP, and may therefore provide less of a stimulus for ventricular dilatation.

Journal of the American College of Cardiology, 2002

The study was done to determine the effects of propranolol, enalaprilat, verapamil, and caffeine ... more The study was done to determine the effects of propranolol, enalaprilat, verapamil, and caffeine on the vasodilatory properties of the adenosine A 2A-receptor agonist ATL-146e (ATL). BACKGROUND ATL is a new adenosine A 2A-receptor agonist proposed as a vasodilator for myocardial stress perfusion imaging. Beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and calcium blockers are commonly used for the treatment of coronary artery disease (CAD), and their effect on ATL-mediated vasodilation is unknown. Dietary intake of caffeine is also common. METHODS In 19 anesthetized, open-chest dogs, hemodynamic responses to bolus injections of ATL (1.0 g/kg) and adenosine (60 g/kg) were recorded before and after administration of propranolol (1.0 mg/kg, ATL only), enalaprilat (0.3 mg/kg, ATL only), caffeine (5.0 mg/kg, ATL only), and verapamil (0.2 mg/kg bolus, ATL and adenosine). RESULTS Neither propranolol nor enalaprilat attenuated the ATL-mediated vasodilation (225 Ϯ 86% and 237 Ϯ 67% increase, respectively, p ϭ NS vs. control). Caffeine had an inhibitory effect (97 Ϯ 28% increase, p Ͻ 0.05 vs. control). Verapamil blunted both ATL-and adenosineinduced vasodilation (63 Ϯ 20% and 35 Ϯ 7%, respectively, p Ͻ 0.05 vs. baseline), and also inhibited the vasodilation induced by the adenosine triphosphate-sensitive potassium (K ATP) channel activator pinacidil. CONCLUSIONS Beta-blockers and ACE inhibitors do not reduce the maximal coronary flow response to adenosine A 2A-agonists, whereas verapamil attenuated this vasodilation through inhibition of K ATP channels. The inhibitory effect of verapamil and K ATP channel inhibitors like glybenclamide on pharmacologic stress using adenosine or adenosine A 2A-receptor agonists should be evaluated in the clinical setting to determine their potential for reducing the sensitivity of CAD detection with perfusion imaging.

Journal of the American College of Cardiology, 1991

Journal of the American College of Cardiology, 1996

Journal of the American College of Cardiology, 2002

(RVEDV), RV end-systolic volume (RVESV), RV ejection fraction (RVEF), and RV mass. The acquisitio... more (RVEDV), RV end-systolic volume (RVESV), RV ejection fraction (RVEF), and RV mass. The acquisition time for real-time cardiac MRI was significantly shorter than that for cine MRI (1±0 versus 13±2 minutes, p<O.001). Both techniques yielded good quality images allowing RV volumetrics. There was good agreement between real-time volumes and cine volumes. The RV measurements obtained with real-time cardiac MRI showed close correlation with those obtained with conventional cine MRI (RVEDV: r=0.94, p<0.001, RVESV: r=0.95, p=0.001, RVEF: r-0.66, p<0.05, RV mass: r=0.94, p<0.005). Conclusions: Compared with the conventional cine MR imaging, real-time MR imaging shows markedly reduced acquisition time in the assessment of RV volumes and mass. We conclude that real-time MR imaging system is a valuable technique that provides accurate assessment of RV volumes and mass in a time-efficient manner.

Journal of Nuclear Cardiology, 1994

Background. The purposes of this study were to determine (1) whether perfusion defects and differ... more Background. The purposes of this study were to determine (1) whether perfusion defects and differential teboroxime clearance observed on serial postdipyridamole planar gamma camera images have utility in differentiating severity of coronary stenosis in canine myocardium and (2) whether single-zone (99mTC activity in one zone over time) or dual-zone (99mTc activity ratio in two zones over time) quantitative analysis provides the most useful characterization of tehoroxime clearance kinetics. Methods and Results. Accordingly, eight dogs received a mild coronary stenosis (mierosphere-determined, post-dipyridamole flow _> 0.4 ml/min/gm) and 10 dogs received a severe coronary stenosis (flow < 0.3 mUmin/gm). In three control dogs there was no coronary stenosis. Tehoroxime (5 mCi) was injected after dipyridamole (0.8 mg/kg/min), and gamma camera imaging was begun immediately and continued for 60 minutes. Quantitative analysis of single-zone clearance curves indicated that teboroxime retention for both zones of stenosis (mild = 66.3% _+ 2.8%, SEM; severe = 69.5%-+ 3.7%) was significantly greater than control zone retention (54.5%-3.0%; p < 0.05) at 10 minutes. Retention in mild (37.2%-1.9%, SEM) and severe (42.3%-1.5%) zones of stenosis was significantly different from each other at 60 minutes (/7 < 0.05). There was a significant direct, linear correlation of flow with teboroxime clearance at 20 minutes (r = + 0.74, normal and ischemic zones). Quantitative analysis with dual-zone count ratios (stenosed/normal) demonstrated significant differences among control (0.93-+ 0.04, SEM), mild stenoses (0.54-0.04), and severe stenoses (0.39 _ 0.03) as early as 2 minutes after administration of 99mTc.labeled teboroxime. The correlation coefficient for flow ratio versus dual-zone counts/pixel ratio at 20 minutes was r = + 0.74. Conclusion. Thus in this canine stenosis model with dipyridamole, gamma camera imaging could distinguish mild from severe coronary stenoses by either single-or dual-zone analysis.

Journal of Cardiovascular Magnetic Resonance, 2009

Introduction: Prophylactic implantation of a cardioverter/ defibrillator (ICD) has been shown to ... more Introduction: Prophylactic implantation of a cardioverter/ defibrillator (ICD) has been shown to reduce mortality in patients with chronic myocardial infarction (CMI) and an increased risk for life threatening ventricular arrhythmia (VA). The use of ICDs in this large patient population is still limited by high costs and possible adverse events including inappropriate discharges and progression of heart failure. VA is related to infarct size and seems to be related to infarct morphology. Contrast enhanced cardiovascular magnetic resonance imaging (ceCMR) can detect and quantify myocardial fibrosis in the setting of CMI and might therefore be a valuable tool for a more accurate risk stratification in this setting. Hypothesis: ceCMR can identify the subgroup developing VA in patients with prophylactic ICD implantation following MADIT criteria. Methods: We prospectively enrolled 52 patients (49 males, age 69 ± 10 years) with CMI and clinical indication for ICD therapy following MADIT criteria. Prior to implantation (36 ± 78 days) patients were investigated on a 1.5 T clinical scanner (Siemens Avanto © , Germany) to assess left ventricular function (LVEF), LV end-diastolic volume (LVEDV) and LV mass (sequence parameters: GRE SSFP, matrix 256 × 192, short axis stack; full LV coverage, no gap; slice thickness 6 mm). For quantitative assessment of infarct morphology late gadolinium enhancement (LGE) was performed including measurement of total and relative infarct mass (related to LV mass) and the degree of transmurality (DT) as defined by the percentage of transmurality in each scar. (sequence parameters: inversion recovery gradient echo; matrix 256 × 148, imaging 10 min after 0.2 μg/kg gadolinium DTPA; slice orientation equal to SSFP). MRI images were analysed using dedicated software (MASS © , Medis, Netherlands). LGE was defined as myocardial areas with signal intensity above the average plus 5 SD of the remote myocardium. After implantation, patients were followed up including ICD readout after 3 and than every 6 months for a mean of 945 ± 344 days. ICD data were evaluated by an experienced electrophysiologist. Primary endpoint was the occurrence of an appropriate discharge (DC), antitachycard pacing (ATP) or death from cardiac cause. Results: The endpoint occurred in 10 patients (3 DC, 6 ATP, 1 death). These patients had a higher relative infarct mass (28 ± 7% vs. 22 ± 11%, p = 0.03) as well as high degree of transmurality (64 ± 22% vs. 44 ± 25%, p = 0.05). Their LVEF (29 ± 8% vs. 30 ± 4%, p = 0.75), LV mass (148 ± 29 g vs. 154 ± 42 g, p = 0.60), LVEDV (270 ± 133 ml vs. 275 ± 83 ml, p = 0.90) or total infarct mass (43 ± 19 g vs. 37 ± 21 g, p = 0.43) were however not significant from the group with no events. In a cox proportional hazards regression model including LVEF, LVEDV, LV mass, DT and age, only degree of transmurality and relative infarct mass emerged as independent predictors of the primary end point (p = 0.009). Conclusion: In CMI-patients fulfilling MADIT criteria ceCMR could show that the extent and transmurality of myocardial scarring are independent predictors for life threatening ventricular arrhythmia or death. This additional information could lead to more precise risk stratification and might reduce adverse events and cost of ICD therapy in this patient population. Larger trials are needed to confirm this finding.

The online version of this article, along with updated information and services, is located on the

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2004

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2003

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2002

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2001

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1995

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2004

Journal of the American College of Cardiology, 2003

Journal of the American College of Cardiology, 2000

Journal of the American College of Cardiology, 1995

Journal of the American College of Cardiology, 2002

Journal of the American College of Cardiology, 1991

Journal of the American College of Cardiology, 1996

Journal of the American College of Cardiology, 2002

Journal of Nuclear Cardiology, 1994

Journal of Cardiovascular Magnetic Resonance, 2009