logo

Proportion of viable myocardium is more reliable than semi-quantitative score in predicting functional recovery: a pilot study of PET myocardial viability imaging

RADIOCHEMISTRY, RADIOPHARMACEUTICALS AND NUCLEAR MEDICINE

Proportion of viable myocardium is more reliable than semi-quantitative score in predicting functional recovery: a pilot study of PET myocardial viability imaging

ZHANG Jiayin
KONG Ye
ZHOU Jian
ZHANG Jianfeng
ZHANG Liying
WANG Chao
ZHU Chengmo
LI Biao
Nuclear Science and TechniquesVol.19, No.1pp.32-38Published in print 20 Feb 2008
50501

PET myocardial viability imaging is the "gold standard" for the non-invasive assessment of myocardial viability. The research aims to find out the best methods of imaging interpretation in predicting the postoperative functional recovery. Twenty-one CAD patients with multi-vessel involvement were recruited. All patients underwent gated myocardial perfusion imaging(G-MPI) and FDG PET myocardial imaging within 2 weeks before coronary artery bypass grafting. The postoperative G-MPI was performed in all patients 3 months after the surgery. Out of the total 420 segments, 164 segments of ischemic myocardium were detected by preoperative G-MPI. Among them, 93 ischemic segments were identified as non-viable(difference score≥0) and the rest 71 segments were identified as viable(difference score<0). The proportion of viable segments (the ratio of viable segments versus ischemic segments) and summed difference score of metabolism to perfusion were calculated. The patients were further divided into 2 groups according to the proportion of viable myocardium: groupⅠ(the proportion≥50%, 12 cases) and groupⅡ(the proportion<50%, 9 cases) while another division was made according to SDS: group A (SDS≥0), group B (-5≤SDS<0) and group C (SDS<-5). The diagnostic accuracy of proportion of viable segments and SDS in predicting the post-revascularization improvement in the left ventricular ejection fraction by at least 5 or more ejection fraction units was 88.89% (8/9) and 55.56% (5/9) respectively. It is concluded that both approaches allow accurate evaluation of myocardial viability. Furthermore, the proportion of viable myocardium is more reliable in predicting the postoperative functional recovery.

Myocardial viabilityDeoxyglucosePETCoronary artery disease
References
[1] Sergeant P. Eur J Cardiothorac Surg, 2004, 26: S4-7.
[2] Patterson R E, Pilcher W C. Semin Thorac Cardiovasc Surg, 1995, 7: 214-226.
[3] Ragosta M, Beller G A. Clin Cardiol, 1993, 16: 531-538.
[4] Marwick T H, Zuchowski C, Lauer M S, et al. J Am Coll Cardiol, 1999, 33: 750-758.
[5] Mahmarian J, Schwaiger M, Pennell D, et al. J Nucl Cardiol, 2001, 8: 224-316.
[6] Carli M F D, Asgarzadie F, Schelbert H R, et al. Circulation, 1995, 92: 3436-3444.
[7] Acampa W, Cuocolo A, Petretta M, et al. J Nucl Cardiol, 2002, 9: 33-40.
[8] Matsunari I, Fujino S, Taki J, et al. J Nucl Med, 1995, 36: 1961-1967.
[9] Udelson J E, Coleman P S, Metherall J, et al. Circulation 1994, 89: 2552-2561.
[10] Pirich C, Schwaiger M. Rev Port Cardiol, 2000, 19: 89-100.
[11] Bax J, Wijins W. J Nucl Med, 1999, 40: 1893-1895.
[12] Yoshinaga K, Morita K, Yamada S, et al. J Nucl Med 2001, 42: 838-844.
[13] Port S C. J Nucl Cardiol, 1999, 6: G67-77.
[14] Wang F, Lee K, Tubau J, et al. J Nucl Med, 2002, 43s: 186p5.
[15] Schelbert H R, Beanlands R, Bengel F, et al. J Nucl Cardiol, 2003, 10: 562-567.
[16] Berman D S, Hayes S W, Shaw L J. Curr Probl Cardiol, 2001, 26: 94-100.
[17] Sharir T, Germano G, Kang X, et al. J Nucl Med, 2001, 42: 831-837.
[18] Wu Y W, Huang P J, Lee C M, et al. J Nucl Cardiol, 2005, 12: 451-459.
[19] Yamakawa Y, Takahashi N, Ishikawa T, et al. Nucl Med, 2004, 18: 375-383.
[20] Slart R H, Bax J J, de Boer J, et al. Eur J Nucl Med Mol Imaging, 2005, 32: 972-979.
[21] Schoder H, Campisi R, Ohtake T, et al. J Am Coll Cardiol, 1999, 33: 1328-1337.
[22] Pagano D, Townend J N, Littler W A, et al. J Thor Cardiovasc Surg, 1998, 115: 791-799.
[23] Gerber B L, Ordoubadi F F, Wijns W, et al. Eur Heart J, 2001, 22: 1691-1701.