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

Proportion of viable myocardium is more reliable than semi-quantitative score in predicting functional recovery: a pilot study of PET myocardial viability imaging 1 first-author 2 2 2 1 1 1 1 corresp Corresponding author. E-mail address: biaoli63@yahoo.com.cn Corresponding author. E-mail address: biaoli63@yahoo.com.cn biaoli63@yahoo.com.cn Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China Department of Cardiac / Thoracic Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China Department of Cardiac / Thoracic Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China 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 viability Deoxyglucose PET Coronary artery disease References Sergeant P . Eur J Cardiothorac Surg , 2004 , 26 : S4 - 7 . Eur J Cardiothorac Surg Patterson R E , Pilcher W C . Semin Thorac Cardiovasc Surg , 1995 , 7 : 214 - 226 . Semin Thorac Cardiovasc Surg Ragosta M , Beller G A . Clin Cardiol , 1993 , 16 : 531 - 538 . Clin Cardiol Marwick T H , Zuchowski C , Lauer M S , et al . J Am Coll Cardiol , 1999 , 33 : 750 - 758 . J Am Coll Cardiol Mahmarian J , Schwaiger M , Pennell D , et al . J Nucl Cardiol , 2001 , 8 : 224 - 316 . J Nucl Cardiol Carli M F D , Asgarzadie F , Schelbert H R , et al . Circulation , 1995 , 92 : 3436 - 3444 . Circulation Acampa W , Cuocolo A , Petretta M , et al . J Nucl Cardiol , 2002 , 9 : 33 - 40 . J Nucl Cardiol Matsunari I , Fujino S , Taki J , et al . J Nucl Med , 1995 , 36 : 1961 - 1967 . J Nucl Med Udelson J E , Coleman P S , Metherall J , et al . Circulation 1994 , 89 : 2552 - 2561 . Circulation Pirich C , Schwaiger M . Rev Port Cardiol , 2000 , 19 : 89 - 100 . Rev Port Cardiol Bax J , Wijins W . J Nucl Med , 1999 , 40 : 1893 - 1895 . J Nucl Med Yoshinaga K , Morita K , Yamada S , et al . J Nucl Med 2001 , 42 : 838 - 844 . J Nucl Med Port S C . J Nucl Cardiol , 1999 , 6 : G67 - 77 . J Nucl Cardiol Wang F , Lee K , Tubau J , et al . J Nucl Med , 2002 , 43s : 186p5 . J Nucl Med Schelbert H R , Beanlands R , Bengel F , et al . J Nucl Cardiol , 2003 , 10 : 562 - 567 . J Nucl Cardiol Berman D S , Hayes S W , Shaw L J . Curr Probl Cardiol , 2001 , 26 : 94 - 100 . Curr Probl Cardiol Sharir T , Germano G , Kang X , et al . J Nucl Med , 2001 , 42 : 831 - 837 . J Nucl Med Wu Y W , Huang P J , Lee C M , et al . J Nucl Cardiol , 2005 , 12 : 451 - 459 . J Nucl Cardiol Yamakawa Y , Takahashi N , Ishikawa T , et al . Nucl Med , 2004 , 18 : 375 - 383 . Nucl Med Slart R H , Bax J J , de Boer J , et al . Eur J Nucl Med Mol Imaging , 2005 , 32 : 972 - 979 . Eur J Nucl Med Mol Imaging Schoder H , Campisi R , Ohtake T , et al . J Am Coll Cardiol , 1999 , 33 : 1328 - 1337 . J Am Coll Cardiol Pagano D , Townend J N , Littler W A , et al . J Thor Cardiovasc Surg , 1998 , 115 : 791 - 799 . J Thor Cardiovasc Surg Gerber B L , Ordoubadi F F , Wijns W , et al . Eur Heart J , 2001 , 22 : 1691 - 1701 . Eur Heart J 10.1016/S1001-8042(08)60018-4 R445.53 2007-12-04 2008-02-20 2021-01-19 2008 Nuclear Science and Techniques 01 19