News | May 18, 2012

Novel Imaging for Sudden Cardiac Arrest Could Better Identify Patients Who Would Benefit From ICDs

May 18, 2012 - New research from the University at Buffalo suggests that cardiologists may have a new way to identify patients who are at the highest risk of sudden cardiac arrest, and the most likely to benefit from receiving an implantable cardiac defibrillator (ICD).

ICDs are used to prevent sudden cardiac arrest in patients with advanced heart disease, but many patients’ devices are never triggered. New research suggests that imaging the loss of nerve function in the heart may identify those patients at greatest risk of developing a life-threatening arrhythmia.

That finding was reported May 10 at 11 a.m. ET as a Late-Breaking Clinical Trial at the Heart Rhythm Society’s 33rd Annual Scientific Sessions in Boston.

The UB PAREPET study (Prediction of Arrhythmic Events with Positron Emission Tomography [PET]), is the largest PET imaging study ever done on sudden cardiac arrest.

UB researchers used PET imaging to quantify the patients’ amount of denervated myocardium, where sympathetic nerves in the heart have died or become damaged due to inadequate blood flow. This was accomplished by imaging the heart’s ability to take up a radioactive tracer of norepinephrine, the neurotransmitter released from the heart’s neurons, using the cyclotron-generated radiopharmaceutical 11C-hydroxyephedrine.

“The principal question we posed with this study was whether the amount of denervated myocardium could predict sudden cardiac arrest,” says James A. Fallavollita, M.D., UB professor of medicine and lead author on the study. “We found that when at least 38 percent of the heart was denervated, there was a significant increase in the risk of sudden cardiac arrest.”

“Ultimately, we wanted to develop an approach that could tackle the problem of identifying a larger portion of the patients with coronary artery disease who are at risk of developing sudden cardiac arrest,” explains John M. Canty Jr., M.D., the Albert and Elizabeth Rekate professor of medicine in the UB School of Medicine and Biomedical Sciences and UB's chief of cardiovascular medicine, who was principal investigator of the research. “Since many patients who suffer a cardiac arrest do not have severely depressed heart function, PET imaging may be able to identify high risk individuals who, in the future, could be considered candidates for an ICD.”

Currently, the main criteria for determining who gets an ICD is a measurement of heart function called the ejection fraction, which is the percentage of blood pumped by the heart with each beat. Individuals with an ejection fraction of 35 percent or less are considered candidates for ICDs because they have a significant risk of sudden cardiac arrest.

Funded by the National Institutes of Health, PAREPET involved 204 patients from western New York with advanced heart disease.

The current research study is a prime example of translational medicine because it came directly out of the laboratory research the UB researchers had performed in animals with chronic ischemic heart disease. These preclinical studies demonstrated that the risk of developing ventricular fibrillation was related to regional myocardial denervation.

“This is as clear an example of translational medicine as there is, with a project being taken from bench-to-bedside by the same investigative team,” says Canty. “In our preclinical research, we studied factors that lead to sudden cardiac arrest in animals. This led directly to the human study. This important finding may ultimately impact the care of patients with heart disease.”

This summer, Canty and Fallavollita will be among the core of UB translational medicine researchers who will move their laboratories into the university’s Clinical and Translational Research Center, in the top four floors of the new $291 million joint UB-Kaleida Health building now under construction on the Buffalo Niagara Medical Campus.

Other UB investigators participating in the PAREPET study included Michael E. Cain, M.D., vice president for health sciences and dean of the medical school, and Anne B. Curtis, Charles and Mary Bauer Professor and chair of the Department of Medicine, both international experts in cardiac electrophysiology; Sunil Baldwa, M.D., clinical assistant professor of medicine; Andrew J. Luisi, M.D., clinical assistant professor of medicine; Alan Hutson, chair and professor of the Department of Biostatistics in the School of Public Health and Health Professions; Terry Mashtare, Ph.D., research assistant professor in the same department; Suzanne Michalek, RN, clinical nurse specialist; and Brendan Heavy, MPH, research scientist in the Department of Medicine.

For more information: www.buffalo.edu/news/6903.

Related Content

Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Smartphone Addiction Creates Imbalance in Brain
News | Mobile Devices | January 11, 2018
Researchers have found an imbalance in the brain chemistry of young people addicted to smartphones and the internet,...
Emergency Radiologists See Inner Toll of Opioid Use Disorders

Rates of Imaging Positivity for IV-SUDs Complications. Image courtesy of Efren J. Flores, M.D.

News | Clinical Study | January 11, 2018
January 11, 2018 – Emergency radiologists are seeing a high prevalence of patients with complications related to opio
Minimally Invasive Treatment Provides Relief from Back Pain

Lumbar spine MRI showing disc herniation and nerve root at baseline and one month after treatment

News | Interventional Radiology | January 11, 2018
The majority of patients were pain free after receiving a new image-guided pulsed radiofrequency treatment for low back...
Study Finds No Evidence that Gadolinium Causes Neurologic Harm

MR images through, A, C, E, basal ganglia and, B, D, F, posterior fossa at level of dentate nucleus. Images are shown for, A, B, control group patient 4, and the, C, D, first and, E, F, last examinations performed in contrast group patient 13. Regions of interest used in quantification of signal intensity are shown as dashed lines for globus pallidus (green), thalamus (blue), dentate nucleus (yellow), and pons (red).

News | Contrast Media | January 11, 2018
January 11, 2018 — There is no evidence that accumulation in the brain of the element gadolinium speeds cognitive dec
CT Shows Enlarged Aortas in Former Pro Football Players

3-D rendering from a cardiac CT dataset demonstrating mild dilation of the ascending aorta.

News | Computed Tomography (CT) | January 11, 2018
Former National Football League (NFL) players are more likely to have enlarged aortas, a condition that may put them at...

Size comparison between 3-D printed prosthesis implant and a penny.

News | 3-D Printing | January 11, 2018
January 11, 2018 — Researchers using...
RSNA 2017 technical exhibits, expo floor, showing new radiology technology advances.
Feature | RSNA 2017 | January 11, 2018
January 11, 2018 — Here is a list of some of the key clinical study presentations, articles on trends and videos from
Hip Steroid Injections Associated with Bone Changes

58-year-old woman with left hip pain. X-ray from one month prior to the steroid/anesthetic injection demonstrates moderate joint space narrowing (arrows) and bony proliferation (arrowheads).

News | Orthopedic Imaging | January 11, 2018
January 11, 2018 – Osteoarthritis patients who received a steroid injection in the hip had a significantly greater in
Overlay Init