Impaired Coronary Flow Reserve Is the Most Important Marker of Viable Myocardium in the Myocardial Segment-Based Analysis of Dual-Isotope Gated Myocardial Perfusion Single-Photon Emission Computed Tomography
Korean Journal of Radiology
;
: 277-285, 2014.
Article
in English
| WPRIM
| ID: wpr-187061
ABSTRACT
OBJECTIVE:
The aim of this study was to investigate the most robust predictor of myocardial viability among stress/rest reversibility (coronary flow reserve [CFR] impairment), 201Tl perfusion status at rest, 201Tl 24 hours redistribution and systolic wall thickening of 99mTc-methoxyisobutylisonitrile using a dual isotope gated myocardial perfusion single-photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) who were re-vascularized with a coronary artery bypass graft (CABG) surgery. MATERIALS ANDMETHODS:
A total of 39 patients with CAD was enrolled (34 men and 5 women), aged between 36 and 72 years (mean 58 +/- 8 standard in years) who underwent both pre- and 3 months post-CABG myocardial SPECT. We analyzed 17 myocardial segments per patient. Perfusion status and wall motion were semi-quantitatively evaluated using a 4-point grading system. Viable myocardium was defined as dysfunctional myocardium which showed wall motion improvement after CABG.RESULTS:
The left ventricular ejection fraction (LVEF) significantly increased from 37.8 +/- 9.0% to 45.5 +/- 12.3% (p < 0.001) in 22 patients who had a pre-CABG LVEF lower than 50%. Among 590 myocardial segments in the re-vascularized area, 115 showed abnormal wall motion before CABG and 73.9% (85 of 115) had wall motion improvement after CABG. In the univariate analysis (n = 115 segments), stress/rest reversibility (p < 0.001) and 201Tl rest perfusion status (p = 0.024) were significant predictors of wall motion improvement. However, in multiple logistic regression analysis, stress/rest reversibility alone was a significant predictor for post-CABG wall motion improvement (p < 0.001).CONCLUSION:
Stress/rest reversibility (impaired CFR) during dual-isotope gated myocardial perfusion SPECT was the single most important predictor of wall motion improvement after CABG.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Stroke Volume
/
Coronary Artery Disease
/
Coronary Artery Bypass
/
Analysis of Variance
/
Ventricular Function, Left
/
Technetium
/
Coronary Circulation
/
Coronary Disease
/
Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography
/
Myocardial Contraction
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Korean Journal of Radiology
Year:
2014
Type:
Article
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