Myocardial perfusion imaging with 13N-ammonia PET is a strong predictor for outcome

Int J Cardiol. 2013 Aug 10;167(3):1023-6. doi: 10.1016/j.ijcard.2012.03.076. Epub 2012 Apr 3.


Background/objectives: The aim of the present study was to assess the long-term predictive value of myocardial perfusion imaging (MPI) with (13)N-ammonia positron emission tomography (PET) in patients with suspected myocardial perfusion abnormality. At present, outcome data on the predictive value of MPI in (13)N-ammonia PET exist only for rather small patient populations.

Methods: Cardiac perfusion was assessed in 943 consecutive patients using (13)N-ammonia PET, and follow-up was obtained in 698 (74%). 77 patients who underwent early revascularization (<60 days) were excluded and 621 patients were assigned to normal versus abnormal perfusion for outcome analysis. Hard events (cardiac death and non-fatal myocardial infarction) and major adverse cardiac events (MACE; hard events, hospitalization for cardiac reasons and late revascularization) were investigated using the Kaplan-Meier method. Independent predictors for various cardiac events were identified using Cox proportional hazard regression analysis.

Results: During follow-up (5.7 ± 2.5 years), 275 patients had at least 1 cardiac event, including 102 cardiac deaths and 33 non-fatal myocardial infarction. Abnormal perfusion (n=469) was associated with a higher incidence of MACE (P<0.001) and hard events (P<0.001) throughout the 10-year follow-up period.

Conclusions: Cardiac perfusion findings in (13)N-ammonia PET are strong predictors of long-term outcome.

Keywords: (13)N-ammonia; Myocardial perfusion imaging; Outcome; Positron emission tomography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ammonia
  • Female
  • Follow-Up Studies
  • Heart Diseases / diagnostic imaging*
  • Heart Diseases / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging / methods*
  • Nitrogen Radioisotopes*
  • Positron-Emission Tomography / methods*
  • Predictive Value of Tests
  • Registries
  • Retrospective Studies
  • Treatment Outcome


  • Nitrogen Radioisotopes
  • Ammonia