Impact of Positron Emission Tomography Viability Imaging:Guided Revascularizations on Clinical Outcomes in Patients With Myocardial Scar on Single-Photon Emission Computed Tomography Scans
10.3346/jkms.2023.38.e399
- Author:
Jong Sung PARK
1
;
Jang Hoon LEE
;
Chae Moon HONG
;
Bo Eun PARK
;
Yoon Jung PARK
;
Hong Nyun KIM
;
Namkyun KIM
;
Se Yong JANG
;
Myung Hwan BAE
;
Dong Heon YANG
;
Hun Sik PARK
;
Yongkeun CHO
Author Information
1. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2023;38(46):e399-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Positron emission tomography (PET) viability scan is used to determine whether patients with a myocardial scar on single-photon emission computed tomography (SPECT) may need revascularization. However, the clinical utility of revascularization decision-making guided by PET viability imaging has not been proven yet. The purpose of this study was to investigate the impact of PET to determine revascularization on clinical outcomes.
Methods:Between September 2012 and May 2021, 53 patients (37 males; mean age = 64 ± 11 years) with a myocardial scar on MIBI SPECT who underwent PET viability test were analyzed in this study. The primary outcome was a temporal change in echocardiographic findings.The secondary outcome was all-cause mortality.
Results:Viable myocardium was presented by PET imaging in 29 (54.7%) patients.Revascularization was performed in 26 (49.1%) patients, including 18 (34.0%) with percutaneous coronary intervention (PCI) and 8 (15.1%) with coronary artery bypass grafting.There were significant improvements in echocardiographic findings in the revascularization group and the viable myocardium group. All-cause mortality was significantly lower in the revascularization group than in the medical therapy-alone group (19.2% vs. 44.4%, log-rank P = 0.002) irrespective of viable (21.4% vs. 46.7%, log-rank P = 0.025) or non-viable myocardium (16.7% vs. 41.7%, log-rank P = 0.046). All-cause mortality was significantly lower in the PCI group than in the medical therapy-alone group (11.1% vs. 44.4%, log-rank P < 0.001).
Conclusion:Revascularization improved left ventricular systolic function and survival of patients with a myocardial scar on SPECT scans, irrespective of myocardial viability on PET scans.
