ABSTRACT
Objective: To assess the effect of coronary collateral circulation (CCC) on myocardial viabilityin patients with chronic total occlusion of left anterior descending (LAD) artery. Methods: A total of 101 consecutive patients with confirmed diagnosis of total LAD occlusion in our hospital were enrolled. Rest 99mTc-MIBISPECT myocardial perfusion and 18F-FDG PET were performed, in addition all patients received coronary angiography (CAG) at 3 months front and back. Both images were reconstructed in the same machine and QPS software was used to obtain the summed rest score (SRS), abnormal resting total perfusion defect (TPD), viable and non-viable myocardium, LVEDV, LVESV and LVEF in relevant patients. Based on CAG result, the patients were divided into 2 groups: CCC group, n=39 and No CCC group, n=62; according to existing old myocardial infarctionand location of LAD occlusion, the patients were further divided into 4 subgroups. The above parameters were compared among different groups. Results: There were 86 male and 15 female patients with the mean age at (59.92±11.43) years. Relevant parameters in CCC group and No CCC groupwere as in SRS: (21.23±9.68) vs (28.56±8.76), TPD: (30.03±13.69) %vs (40.37±12.50) %, viable myocardium: (21.77±13.12) % vs (13.66±9.23) %, non-viable myocardium (8.28±8.58) %vs (27.40±12.97) %, all P<0.05; in LVEDV: (109.82±30.01) ml vs (173.71±57.69) ml, LVESV: (62.82±22.39) ml vs (122.53±51.66) ml, LVEF: (43.85±8.46) % vs (31.03±8.30) %, all P<0.05. Conclusion: Our preliminary study found that CCC could maintain left ventricular rest perfusion, myocardial viability and protect cardiac function in patients with chronic total LAD occlusion.
ABSTRACT
Objective To investigate the relationship between myocardial injury and damage of me-chanical synchrony in the left ventricle of patients with ischemic cardiomyopathy ( ICM) using 99 Tcm-MIBI MPI and gated 18 F-FDG myocardial metabolic PET imaging. Methods A total of 113 ICM patients ( 100 males, 13 females;average age (58±10) years) underwent 99Tcm-MIBI MPI and gated 18F-FDG myocardial metabolic PET imaging from July 2015 to December 2015 in Fu Wai Hospital were retrospectively analyzed. Three-point scoring system was used for quantitative assessment of myocardial ischemia and myocardial in-farction in each segment. Total ischemic score ( TIS) and total scar score ( TSS) of 17 segments were calcu-lated in each patient. The phase bandwidth ( BW) and phase SD were derived from phase analysis. Pearson correlation analysis and logistic regression analysis were used. Results TSS were correlated with BW and SD in all 93 patients with myocardial infarction ( r values:0. 517, 0.470, both P<0.01) and also in a sub-group of 34 patients with myocardial infarction and without myocardial ischemia ( r values: 0. 647, 0. 578, both P<0.01) . There were significant correlations between TIS and BW, SD in 79 patients with myocardial is-chemia ( r values:0.392, 0.378, both P<0.01) , but no significant correlation was found in a subgroup of 20 patients with myocardial ischemia and without myocardial infarction ( r values: 0. 002, -0. 003, both P>0. 05) . Logistic regression analysis showed that the number of myocardial infarction segments and TSS were as-sociated with mechanical dyssynchrony. Conclusion Myocardial infarction is the main factor of left ventricu-lar mechanical dyssynchrony in ICM patients, but chronic myocardial ischemia has no significant influence on mechanical dyssynchrony.
ABSTRACT
Objective To investigate the relationship between myocardial injury and damage of me-chanical synchrony in the left ventricle of patients with ischemic cardiomyopathy ( ICM) using 99 Tcm-MIBI MPI and gated 18 F-FDG myocardial metabolic PET imaging. Methods A total of 113 ICM patients ( 100 males, 13 females;average age (58±10) years) underwent 99Tcm-MIBI MPI and gated 18F-FDG myocardial metabolic PET imaging from July 2015 to December 2015 in Fu Wai Hospital were retrospectively analyzed. Three-point scoring system was used for quantitative assessment of myocardial ischemia and myocardial in-farction in each segment. Total ischemic score ( TIS) and total scar score ( TSS) of 17 segments were calcu-lated in each patient. The phase bandwidth ( BW) and phase SD were derived from phase analysis. Pearson correlation analysis and logistic regression analysis were used. Results TSS were correlated with BW and SD in all 93 patients with myocardial infarction ( r values:0. 517, 0.470, both P<0.01) and also in a sub-group of 34 patients with myocardial infarction and without myocardial ischemia ( r values: 0. 647, 0. 578, both P<0.01) . There were significant correlations between TIS and BW, SD in 79 patients with myocardial is-chemia ( r values:0.392, 0.378, both P<0.01) , but no significant correlation was found in a subgroup of 20 patients with myocardial ischemia and without myocardial infarction ( r values: 0. 002, -0. 003, both P>0. 05) . Logistic regression analysis showed that the number of myocardial infarction segments and TSS were as-sociated with mechanical dyssynchrony. Conclusion Myocardial infarction is the main factor of left ventricu-lar mechanical dyssynchrony in ICM patients, but chronic myocardial ischemia has no significant influence on mechanical dyssynchrony.