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July 5, 2026European Heart Journal - Imaging Methods and PracticeOpen Access

PET-derived LV mass index predicts ~4% higher MACE risk per g/m2 in suspected CAD.

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Why the study?

Does left ventricular hypertrophy assessed by 15O-water PET predict major adverse cardiac events in patients evaluated for suspected CAD?

Population

783 consecutive patients evaluated for suspected coronary artery disease referred for rest-stress PET…

Design

Cohort

Follow-up

median 3.8 years

Key result

PET-derived left ventricular mass index independently predicted major adverse cardiac events (HR 1.04 per g/m2; 95% CI 1.02-1.06; P<0.0001) in patients evaluated for suspected coronary artery disease.

Authors

JSJonathan SigfridssonPSPatrik SvanströmTKTanja Kero

Discussion

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Overview

PET-derived LV metrics may refine risk stratification during CAD PET; hypothesis-generating and requires prospective validation before practice change.

Key Points

  • This study aims to evaluate the prognostic significance of LV hypertrophy metrics derived from PET scans in patients suspected of coronary artery disease.
  • Retrospective analysis of 783 patients undergoing 15O-water PET for suspected CAD.
  • LVMi and WT were calculated from non-ECG-gated resting PET scans, with exclusion of certain cardiomyopathy cases.
  • Primary outcome assessed was major adverse cardiac events (MACE), using Cox hazard ratios for prognostic evaluation.
  • Patients with heart failure showed significantly higher LVMi (HR 1.04 [1.02-1.06] per g/m2, p<0.0001) and WT (HR 1.36 [1.10-1.68] per mm, p=0.0045) than those without heart failure.
  • Among patients without heart failure, 30 experienced MACE during median follow-up of 3.8 years, indicating significant predictive capability of PET metrics.
  • High test-retest repeatability was confirmed in a subset of 21 patients with repeated PET scans.

Study Design

Type

Cohort (n=783)

Structured PICO

Does left ventricular hypertrophy assessed by 15O-water PET predict major adverse cardiac events in patients evaluated for suspected CAD?

P
Population
783 consecutive patients evaluated for suspected coronary artery disease, excluding those with known hypertrophic/infiltrative cardiomyopathy, followed for a median of 3.8 years.
E
Exposure
Measurement of left ventricular mass index (LVMi) and interventricular septal wall thickness (WT) derived from non-ECG-gated resting 15O-water positron emission tomography (PET)
O
Outcome
Major adverse cardiac events (MACE: composite of cardiovascular death or acute HF)composite

Main Result

Hazard Ratio: 1.04 (95% CI 1.02–1.06)

p-value: p=<0.0001

Left ventricular hypertrophy metrics (LVMi and WT) derived from routine 15O-water PET provide independent prognostic information for MACE beyond myocardial perfusion in patients with suspected CAD.

Cite This Study

Sigfridsson et al. (2026) conducted a cohort in suspected coronary artery disease (CAD) (n=783). PET-derived left ventricular hypertrophy metrics (LVMi and WT) was evaluated on major adverse cardiac events (MACE: cardiovascular death or acute HF) (HR 1.04, 95% CI 1.02-1.06, p=<0.0001). PET-derived left ventricular mass index independently predicted major adverse cardiac events (HR 1.04 per g/m2; 95% CI 1.02-1.06; P<0.0001) in patients evaluated for suspected coronary artery disease.

synapsesocial.com/papers/6a49f591f5d1d45b288006d1https://doi.org/10.1093/ehjimp/qyag121
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