Application of adenosine stress-rest gated myocardial perfusion imaging in evaluation of patients with multivessel coronary artery disease after coronary artery bypass grafting
10.3760/cma.j.cn321828-20230620-00178
- VernacularTitle:腺苷负荷－静息门控心肌灌注显像在冠心病多支病变患者冠状动脉旁路移植术后评估中的应用
- Author:
Feipeng WU
1
;
Xiandong ZHENG
;
Qiaofen YANG
;
Qiyan WU
;
Liju HONG
;
Lei YUE
;
Rui YANG
;
Dandan CHEN
;
Youjun ZHOU
Author Information
1. 昆明医科大学附属延安医院核医学科，昆明 650051
- Keywords:
Coronary disease;
Coronary artery bypass;
Myocardial perfusion imaging;
Technetium Tc 99m sestamibi;
Adenosine
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2024;44(7):406-411
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the utility of adenosine stress-rest gated myocardial perfusion imaging (G-MPI) in evaluation of left ventricular (LV) myocardial perfusion, heart function, and synchronization in patients with multivessel coronary artery disease after coronary artery bypass grafting (CABG).Methods:Fifty-five patients (42 males, 13 females, age (59.3±9.0) years) with multivessel coronary artery disease who underwent CABG surgery in Yan′an Hospital Affiliated to Kunming Medical University between January 2021 and June 2023 were retrospectively collected. All of them underwent G-MPI (one-day method) one week before and six months after CABG. Paired t-test or Wilcoxon signed rank test was used to compare LV myocardial perfusion parameters including summed stress score (SSS), summed rest score (SRS), and summed different score (SDS) before and after CABG, as well as cardiac function parameters (LV ejection fraction (EF), LV end-diastolic volume (EDV), LV end-systolic volume (ESV), stroke volume (SV), peak filling rate (PFR)), and LV mechanical contraction synchronization parameters such as phase histogram bandwidth (PHB) and phase standard deviation (PSD). Differences of the changes of parameters after CABG compared to baseline (Δ) between adenosine stress imaging and rest imaging were also compared by Wilcoxon signed rank test. The relationships between rest LVEF, rest PFR and myocardial perfusion parameters were analyzed by Spearman rank correlation analysis. Results:After CABG, the SSS, SRS, and SDS were significantly lower than those before surgery (6(3, 12) vs 16(9, 23), 1(0, 9) vs 4(1, 15), 3(1, 5) vs 8(6, 12); z values: 6.37, 4.84, 6.24, all P<0.001); postoperative rest/stress LVEF(60%(49%, 67%), 58%(48%, 68%)) and PFR (3.67(3.12, 4.28), 3.23(2.77, 4.43) EDV/s) significantly increased compared with preoperative values (51%(33%, 62%), 53%(27%, 61%); 2.76(2.08, 3.52), 2.83(1.86, 3.62) EDV/s; z values: 3.23-5.58, all P<0.01); postoperative rest/stress LVEDV and LVESV were significantly lower than those before surgery ( t values: 6.40, 5.27; z values: 5.33, 5.40; all P<0.001); rest/stress PHB (45°(35°, 70°), 53°(44°, 113°)) and PSD (14.7°(10.9°, 27.3°), 20.0°(14.6°, 33.8°)) were significantly lower than those before surgery (60°(45°, 131°), 83°(58°, 198°), 20.4°(16.0°, 49.1°), 27.2°(19.6°, 60.4°); z values: 4.19-4.81, all P<0.001). The ΔSSS was greater than the ΔSRS, and the ΔPFR was greater in rest imaging than that in stress imaging ( z values: 6.24, 2.77, both P<0.05). Rest LVEF, PFR were negatively correlated with SSS and SRS ( rs values: from -0.741 to -0.431, all P<0.05). Conclusion:The LV myocardial perfusion, function, and mechanical contraction synchronicity information obtained from adenosine stress-rest G-MPI can be used to evaluate the recovery after CABG, which may help to better identify patients who may have adverse cardiac events.
