[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].
OBJECTIVE
To evaluate the impact of viable myocardium assessed by (99)Tc()m-MIBI SPECT and (18)F-fluorodeoxyglucose (FDG) PET imaging in patients with left ventricular aneurysm (LVA) underwent revascularization (RVS).


METHODS
Forty-six consecutive patients with LVA (mean LVEF 36% +/- 7%), underwent (99)Tc(m)-sestamibi SPECT and (18)F-FDG PET examinations and received RVS therapy, were followed-up for a mean period of 80 +/- 27 months. Viable myocardium in aneurysm was defined as perfusion-metabolism 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 improved (> 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.
Zhang
Xiao-li
XL
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China. xlzhang68@yahoo.com
Liu
Xiu-jie
XJ
Hu
Sheng-shou
SS
Thomas
Schindler
S
Tian
Yue-qin
YQ
Gao
Run-lin
RL
Wu
Qing-yu
QY
Wei
Hong-xing
HX
Yang
Xiu-bin
XB
Wang
Hao
H
He
Zuo-xiang
ZX
Schelbert
Heinrich R
HR
D000368:Aged; D019788:Fluorodeoxyglucose F18; D006322:Heart Aneurysm / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D049268:Positron-Emission Tomography; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi