Early risk stratification using Rubidium-82 positron emission tomography in STEMI patients

Adam Ali Ghotbi, Philip Hasbak, Lars Nepper-Christensen, Jacob Lønborg, Kiril Atharovski, Thomas Christensen, Lene Holmvang, Thomas Engstrøm, Rasmus Sejersten Ripa, Andreas Kjær

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Assessment of infarct size after myocardial infarction is predictive of subsequent morphological changes and clinical outcome. This study aimed to assess subacute post-intervention Rubidium-82 ( 82 Rb)-PET imaging in predicting left ventricle ejection fraction, regional wall motion, and final infarct size by CMR at 3-months after STEMI. Methods: STEMI patients undergoing percutaneous coronary intervention were included prospectively. Rest-only 82 Rb-PET perfusion imaging was performed at median 36 hours [IQR: 22 to 50] after the treatment. The extent of hypoperfusion and absolute blood flow (mL·min·g) were estimated on a global and a 17-segment model with dedicated software. At 3-months follow-up patients completed the CMR functional and late gadolinium enhancement imaging. Results: 42 patients were included, but only 35 had follow-up CMR and constituted the study population. Absolute blood flow was significantly lower in the infarct-related territory compared to remote myocardium, P < .005. Extent of hypoperfusion correlated with final infarct size, r = 0.58, P < .001, while blood flow correlated with ejection fraction, r = 0.41, P < .05. In linear mixed models, higher subacute absolute blood flow (β = 4.6, confidence interval [3.5; 5.2], P < .001, R 2  = 0.67) was associated with greater wall motion. Segmental extent of subacute hypoperfusion (β = 0.43 [0.38; 0.49], P < .001, R 2  = 0.58) was associated with the degree of late gadolinium enhancement at 3-months. Conclusions: Subacute rest-only 82 Rb-PET is feasible following STEMI and seems predictive of myocardial function and infarct size at 3-months.

Original languageEnglish
Pages (from-to)471-482
Number of pages12
JournalJournal of Nuclear Cardiology
Issue number2
StatePublished - 15 Apr 2019
Externally publishedYes


  • Positron emission tomography
  • Rubidium-82
  • ST-segment elevation myocardial infarction
  • cardiac magnetic resonance
  • final infarct size
  • myocardial blood flow


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