Clinical value of preoperative viable myocardium and postoperative left ventricular mechanical dyssynchrony for prognosis evaluation in patients undergoing coronary artery bypass graft
10.3760/cma.j.issn.2095-2848.2018.07.003
- VernacularTitle:冠状动脉旁路移植术前存活心肌和术后左心室机械不同步对冠心病患者的预后判断价值
- Author:
Feifei ZHANG
1
;
Jianfeng WANG
;
Xiaoliang SHAO
;
Yongxiang QIAN
;
Wei YANG
;
Wenchong XIN
;
Rong NIU
;
Xiaoxia LI
;
Hui YAN
;
Mei XU
;
Zhen ZHU
;
Xiaosong WANG
;
Yuetao WANG
Author Information
1. 213003,苏州大学附属第三医院、常州市第一人民医院核医学科
- Keywords:
Coronary artery disease;
Coronary artery bypass,off-pump;
Prognosis;
Tomography,emission-computed,single-photon;
Positron-emission tomography;
Technetium Tc 99m sestamibi;
Deoxyglucose
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2018;38(7):466-470
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of preoperative viable myocardium and postoperative left ventricular mechanical dyssynchrony (LVMD) for adverse cardiovascular events(ACE) after coronary artery bypass graft (CABG) in patients with coronary artery disease (CAD) using myocardial perfusion imaging (MPI).Methods From September 2012 to March 2016,49 patients (44 males,5 females,average age:(64±8) years) with CAD were prospectively recruited.All patients underwent 99Tcmmethoxyisobutylisonitrile (MIBI) SPECT gated MPI (GMPI) and 18F-fluorodeoxyglucose (FDG) PET myocardial metabolic imaging to assess myocardial viability preoperatively.GMPI was repeated 4-6 months after CABG to record postoperative LVMD.Phase analysis was used to measure bandwidth (BW) and standard deviation (SD).Regular follow-up was performed,and ACE were taken as the end point.Cox proportional hazard model,Kaplan-Meier method and log-rank test were used to analyze the data.Results The mean duration of follow-up was (3.82±0.80) years,and ACE were present after CABG in 17 CAD patients (34.7％,17/49).Cox multi-analysis revealed that the number of preoperative viable segments (hazard ratio (HR)=0.208,95％ CI:0.068-0.642) and postoperative BW (HR=1.245,95％ CI:1.099-1.411)were independent influencing factors of ACE in CAD patients after CABG (both P＜0.01).Kaplan-Meier survival analysis showed that the incidence of ACE in patients with ＜ 3 viable segments was significantly higher than those with ≥ 3 viable segments (57.1％ (12/21) vs 17.9％ (5/28);x2 =21.023,P＜0.01).The incidence of ACE was significantly higher in the postoperative BW≥98° group than that in the postoperative BW＜98° group (14/19 vs 10％ (3/30);x2 =38.395,P＜0.01).Conclusions Less preoperative viable segments and severe postoperative LVMD are independent risk factors of ACE after CABG in CAD patients.Postoperative LVMD in CAD patients undergoing CABG may have important clinical value in the riskrestratification and prognosis evaluation.
