{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:07:38Z","timestamp":1785150458084,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We sought to study the predictive value of the metabolic heterogeneous zone (HZ) as determined by <jats:sup>18<\/jats:sup>Fluorodeoxyglucose (<jats:sup>18<\/jats:sup>FDG) positron emission tomography (PET) viability studies in ventricular tachycardia (VT) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PET studies utilizing <jats:sup>82<\/jats:sup>Rubidium (<jats:sup>82<\/jats:sup>Rb) tracer for perfusion and <jats:sup>18<\/jats:sup>FDG tracer for viability were analyzed using PMOD (PMOD Technologies) and further analyzed using 684\u2010segment plots. <jats:sup>18<\/jats:sup>FDG uptake was normalized to the area with maximal perfusion on the rest <jats:sup>82<\/jats:sup>Rb study. Metabolic scar, HZ, and healthy segments were defined with perfusion\u2010normalized <jats:sup>18<\/jats:sup>FDG uptake between 0%\u201350%, 50%\u201370%, and &gt;70%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010four VT patients (age, 63\u2009\u00b1\u200912 years) were evaluated with <jats:sup>18<\/jats:sup>FDG\u2010PET viability study. Most (<jats:italic>n<\/jats:italic>\u2009=\u200931) patients underwent VT ablation. Patients were categorized to HZ\u2009&lt;\u2009median versus HZ\u2009\u2265\u2009median based on a median HZ area size of 21.0 cm<jats:sup>2<\/jats:sup>. HZ size was significantly larger in the deceased group than the alive group (35.2 cm<jats:sup>2<\/jats:sup> vs. 18.1 cm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u2009.01). Deaths were significantly higher in HZ\u2009\u2265\u200921 cm<jats:sup>2<\/jats:sup> group than HZ\u2009&lt;\u200921 cm<jats:sup>2<\/jats:sup> group (58.8% vs. 11.8%, <jats:italic>p<\/jats:italic>\u2009=\u2009.005). Survival analysis showed significantly higher mortality in the HZ\u2009\u2265\u200921 cm<jats:sup>2<\/jats:sup> group than the HZ\u2009&lt;\u200921 cm<jats:sup>2<\/jats:sup> group (HR\u2009=\u20094.1, 95% CI: 1.3\u201312.6, <jats:italic>p<\/jats:italic>\u2009=\u2009.016). In a multivariable analysis, HZ was found to be an independent predictor for all\u2010cause mortality (HR\u2009=\u20091.07, 95% CI: 1.02\u20131.12, <jats:italic>p<\/jats:italic>\u2009=\u2009.01)<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased HZ size of myocardium was associated with increased mortality. Metabolic HZ quantification may be of value in risk stratification and management of ischemic and nonischemic patients with VT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15130","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T03:00:35Z","timestamp":1624503635000},"page":"2238-2245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Metabolic heterogeneous zone assessed by <sup>18<\/sup>FDG\u2010PET is predictive of postablation mortality in patients with ventricular tachycardia"],"prefix":"10.1111","volume":"32","author":[{"given":"Brian","family":"Miller","sequence":"first","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9431-7997","authenticated-orcid":false,"given":"Rama","family":"Vunnam","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olurotimi","family":"Mesubi","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark F.","family":"Smith","sequence":"additional","affiliation":[{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"},{"name":"Department of Radiology and Nuclear Medicine University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wengen","family":"Chen","sequence":"additional","affiliation":[{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"},{"name":"Department of Radiology and Nuclear Medicine University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagat Bandhu","family":"Mahat","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soren M.","family":"Bentzen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"See","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Restrepo","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Shorofsky","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasken","family":"Dilsizian","sequence":"additional","affiliation":[{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"},{"name":"Department of Radiology and Nuclear Medicine University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timm\u2010Michael L.","family":"Dickfeld","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Arrhythmia Cardiology Imaging Group (MACIG) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.3.915"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.613414"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.653568"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.108.826529"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198604033141405"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.2.578"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.9.843"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02489-0"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90407-R"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2008.01377.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2007.10.001"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq345"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.109.889311"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.112.000191"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)80026-D"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.000537"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.118.211698"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.11.1288"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1067\/mnc.2002.123122"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.1.26"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.3.941"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-010-0182-2"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.08.020"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-014-0555-0"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc0202.102123"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.4137\/CMC.S730"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.90.2.735"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.02.065"},{"issue":"12","key":"e_1_2_7_30_1","first-page":"1989","article-title":"Usefulness of fasting 18F\u2010FDG PET in identification of cardiac sarcoidosis","volume":"45","author":"Okumura W","year":"2004","journal-title":"J\u00a0Nucl\u00a0Med"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.09.022"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.0000125628.57672.CF"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00810.2011"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.02.058"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.05.036"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.15130","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.15130","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.15130","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T17:37:26Z","timestamp":1692985046000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.15130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":34,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/jce.15130"],"URL":"https:\/\/doi.org\/10.1111\/jce.15130","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]},"assertion":[{"value":"2020-09-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}