1.Impact of viable myocardium assessed by 99Tcm-MIBI SPECT and 18F-FDG PET imaging on clinical outcome of patients with left ventricular aneurysm underwent revascularization
Xiao-Li ZHANG ; Xiu-Jie LIU ; Sheng-Shou HU ; Schindler THOMAS ; Yue-Qin TIAN ; Run-Lin GAO ; Qing-Yu WU ; Hong-Xing WEI ; Xiu-Bin YANG ; Hao WANG ; Zuo-Xiang HE ; R.Schelbert HEINRICH
Chinese Journal of Cardiology 2008;36(11):999-1003
Objeetive To evaluate the impact of viable myocardium assessed by 99Tcm-MIBI SPECT and 18F-flourodeoxyglucose(FDG) PET imaging in patients with left ventricular aneurysm(LNA) underwent revascularization (RVS).Methods Forty-six consecutive patients with LVA (mean LVEF 36%±7%),underwent 99Tcm-sestamibi SPECT and 18F-FDG PET examinations and received RVS therap,were followed-up for a mean period of 80±27 months.Viable myocardium in anenrysm was defined as perfusionmetabolism mismatch score (MMS) ≥2.0.Patients were divided into four groups by aneurysm viability and aneurysmectomy.Group A1 (n=8):viability-;Group A2 (n=15):viability-,aneurysmectomy;Group B1 (n=10):viability+;and Group B2 (n=13):viability+,aneurysmectomy.Results The cardiac event rates during follow up were similar among groups [A1(25%,2/8),B1(40%,6/15),A2(20%,2/10) and B2(31%,4/13:P＞0.05].After revascularization,LVEF was impmved (＞10%) in groups A2,B1 and B2(P＜0.05).Multivariate logistic regression analysis showed that LV-MMS(OR=2.34,95% CI 1.08-5.06,P＜0.05).distal vessel disease(OR=0.008,95% CI 0.001-0.560,P＜0.05) and nonaneurysm perfusion score (OR=0.24.95% CI 0.07-0.85.P＜0.05) were significantly associated with the improvement of LVEF after revascularization.Conclusions Long term cardiac events rate post revascularization was not affected by viable myocardium or aneurysmectomy in LVA patients.Viable myocardium in LVA patients was associated with better LVEF improvement after revascularization.
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