[Clinical impact of positron emission tomography by coincidence system with 18F-FDG on therapeutic decision-making of patients with ischemic cardiomyopathy after myocardial infarction].
OBJECTIVE
To evaluate the influence of the myocardium viability study by coincidence imaging using 18F-FDG in the clinical decision-making of patients with ischemic cardiomyopathy and left ventricular dysfunction.


METHODS
Thirty-one patients were submitted to myocardial viability study with 18F-FDG by coincidence imaging between September 2003 and November 2004. The physician answered a questionnaire about the choice of therapeutic procedure before and after PET.


RESULTS
Twenty-seven patients (87%) had myocardial viability. Twenty-one (68%) physicians thought that PET changed the therapeutic procedure for their patients and 27 (87%) considered that PET added to the therapeutic decision. The current treatment decision (clinical or revascularization) correlated with myocardial viability (p=0.006).


CONCLUSIONS
Coincidence imaging is a useful tool to help physicians in a difficult decision about the best treatment for patients with ischemic cardiomyopathy. Symptoms, electrocardiogram, ejection fraction and myocardial fibrosis area did not correlate with myocardium viability, so they should not be used to decide whether to perform a myocardial viability study or not.
Felix
Renata Christian Martins
RC
Serviço de Medicina Nuclear, Hospital Pró-Cardíaco, Rio de Janeiro, RJ. renatafelix@cardiol.br
Correa
Patrícia Lavatori
PL
de Azevedo
Jader Cunha
JC
Dohmann
Hans Fernando da Rocha
HF
Mesquita
Evandro Tinoco
ET
Mesquita
Cláudio Tinoco
CT
D003658:Decision Making, Computer-Assisted; D004562:Electrocardiography; D005260:Female; D019788:Fluorodeoxyglucose F18; D006321:Heart / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D009204:Myocardial Revascularization; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi