Relationship between collateral circulation and viable myocardium in patients with coronary chronic total occlusion
10.3760/cma.j.cn321828-20240921-00328
- VernacularTitle:冠状动脉慢性完全闭塞病变患者侧支循环与存活心肌的关系
- Author:
Yaqi LIU
1
;
Xiaoyu YANG
;
Feifei ZHANG
;
Bao LIU
;
Jianfeng WANG
;
Mei XU
;
Yuetao WANG
;
Xiao-liang SHAO
Author Information
1. 苏州大学附属第三医院、常州市第一人民医院核医学科，苏州大学核医学与分子影像临床转化研究所，常州 213003
- Publication Type:Journal Article
- Keywords:
Coronary disease;
Collateral circulation;
Myocardium;
Myocardial perfusion imaging;
Technetium Tc 99m sestamibi;
Positron-emission tomography;
Fluorodeoxygl
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(10):583-588
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between collateral circulation and viable myocardium (VM) in patients with coronary chronic total occlusion (CTO).Methods:A total of 88 patients (76 males, 12 females, age (61.0±9.8) years) with coronary CTO were retrospectively analyzed. All patients underwent both 99Tc m-methoxyisobutylisonitrile (MIBI) SPECT myocardial perfusion imaging and 18F-FDG PET myocardial metabolism imaging for evaluation of VM at the First People′s Hospital of Changzhou between September 2012 and June 2023, and they were scheduled to receive coronary revascularization. The perfusion/metabolism mismatch myocardium was regarded as VM. The VM index within the CTO region was calculated, reflected the quantities of VM: VM index=(summed rest score within the CTO region-summed 18F-FDG uptake score within the CTO region)/reduced perfusion myocardial segments×4×100%. Rentrop grading of collateral circulation was performed based on coronary angiography. The differences of VM index within the CTO region between poor-developed (PD, Rentrop grade 0-1) and well-developed (WD, Rentrop grade 2-3) collateral circulation, and among different Rentrop grades were analyzed by the independent-sample t test or Kruskal-Wallis rank sum test. The linear regression analysis was used to evaluate the relationship between Rentrop grading and VM index within the CTO region. The ROC curve was constructed to analyze the predictive value of Rentrop grading for VM within the CTO region. Results:The VM index within the CTO region was significantly higher in WD patients ( n=54) compared to those in PD patients ( n=34): (45.8±16.3)% vs (21.3±16.7)% ( t=-6.79, P<0.001). Moreover, the VM index within the CTO region increased with increased Rentrop grade, and there was a significant difference among 4 groups ( H=30.22, P<0.001). Multiple linear regression analysis showed that only the Rentrop grading was an independent influencing factor for the VM index within the CTO region ( β=9.29, 95% CI: 5.91-12.67, P<0.001). ROC curve showed that the sensitivity and specificity of Rentrop grading score≥2 for predicting the presence or absence of VM within the CTO region were 65.8%(52/79) and 7/9, with the AUC of 0.724(95% CI: 0.619-0.814). Conclusions:In CTO patients who are scheduled for revascularization and evaluation of VM, as the Rentrop grading increases, the VM index within the CTO region also increases. The presence of VM within the CTO region can be predicted with Rentrop grading score ≥2.
