Role of PET-CT in the assessment of myocardial viability in patients with left ventricular dysfunction

Srivatsava, Madhur Kumar; Indirani, M; Sathyamurthy, I; Sengottuvelu, G.; Jain, Anjali; Simon, Shelley

doi:10.1016/j.ihj.2015.11.017

Cited by 9 publications

(5 citation statements)

References 20 publications

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“…In this study, .in myocardial segments with CMR delayed enhancement scores of 3 and 4, 15% of them had hibernating myocardia diagnosed by PET myocardial perfusion and metabolism. Previous studies indicate that about one-third of segments with transmural myocardial infarction have hibernating myocardium [ 8 ], that may be attributed to the mixing of necrotic and viable myocardium (hibernating myocardium) during the process of myocardial infarction. .DE-CMR could not accurately identify these hibernating myocardium.…”

Section: Discussionmentioning

confidence: 99%

“…Viable myocardium refers to dysfunctional myocardial tissue that is still capable of surviving despite systolic dysfunction and either a reduction (hibernation) or non-reduction (stunning) in myocardial perfusion. These cells still possess intact membrane integrity, cellular metabolism, and the potential contraction reserve [ 8 ]. Currently, several imaging methods are available for detecting viable myocardium mainly include dobutamine stress echocardiography, single-photon emission computed tomographic myocardial perfusion imaging (SPECT), myocardial metabolism imaging (including oxygen metabolism, fatty acid metabolism, and glucose metabolism), and delayed enhancement cardiac magnetic resonance imaging (DE-CMR).…”

Section: Introductionmentioning

confidence: 99%

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Determination of viable myocardium through delayed enhancement cardiac magnetic resonance imaging combined with 18F-FDG PET myocardial perfusion/metabolic imaging before CABG

Xu,

Zhang,

Liu

et al. 2024

Int J Cardiovasc Imaging

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Purpose: Study aims to investigate the consistency of delayed enhancement cardiac magnetic resonance imaging (DE-CMR) and 18F-FDG PET myocardial imaging in evaluating myocardial viability before CABG. Methods: The study analyzed data from 100 patients who were examined with DE-CMR, PET imaging, and echocardiography before and after CABG. All subjects were followed up for 6–12 month post- CABG. Results: DE-CMR and PET imaging have high consistency (90.1%; Kappa value = 0.71, p < 0.01) in determining myocardial viability. The degree of delayed enhancement was negatively correlated with the improvement in myocardial contractile function in this segment after revascularization (P < 0.001). The ratio of scarred myocardial segments and total DE score was significantly lower in the improvement group than non-improvement group. Multivariate regression identified that hibernating myocardium (OR = 1.229, 95%CI: 1.053–1.433, p = 0.009) was influencing factor of LVEF improvement after CABG. Conclusion: Both imaging techniques are consistent in evaluating myocardial viability. Detecting the number of hibernating myocardium by PET is also important to predict the left heart function improvement after CABG.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determination of viable myocardium through delayed enhancement cardiac magnetic resonance imaging combined with 18F-FDG PET myocardial perfusion/metabolic imaging before CABG

Xu,

Zhang,

Liu

et al. 2024

Int J Cardiovasc Imaging

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“…Positron emission tomography/computed tomography (PET/CT) is a highly sensitive and non-invasive molecular imaging modality which provides an opportunity to explore various pathophysiological processes within MI in vivo by using various radiotracers [ 21 , 22 ]. It could provide quantitative and semi-quantitative information of local anatomical morphology, metabolism and functional parameters [ 23 ]. Therefore, it may be used to dynamically and real-timely evaluate the pathophysiological characteristics of MIRI in vivo at the molecular level, including blood perfusion, cardiomyocyte metabolism and cell activity.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the cardioprotective effect of metformin on myocardial ischemia–reperfusion injury using dynamic 18F-FDG micro-PET/CT imaging

Shen

et al. 2022

BMC Cardiovasc Disord

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Background The molecular mechanisms of protective effect of metformin (Met) on ischemic myocardium have not been fully understood. This study aims to evaluate the cardioprotective effect of metformin on myocardial ischemia–reperfusion injury (MIRI) in rat models at different time points using dynamic 18F-FDG micro-PET/CT imaging. Methods The I/R injury model in SD rats was established by ligation of left anterior descending coronary artery near the pulmonary arch root for 30 min. SD rats (n = 12) were randomly divided into 2 groups: Control group (n = 6) without any intervention and Met group (n = 6) with oral administration of metformin (50 mg/kg) twice a day. Gated 18F-FDG (40Mbq) micro-PET/CT imaging was performed for 10 min at different time points (day 1st, day 7th, day 14th and day 30th after operation). Volumes of interest were drawn to identify different myocardium regions (ischemia center, peri-ischemia area and remote area). Standardized uptake values (SUVs) (SUVmean and SUVmax) were analyzed to evaluate the FDG uptake activity, and then the center/remote ratio was calculated. In addition, the left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV) and LV ejection fraction (LVEF) were obtained. On the 30th day, all rats were scarified and myocardial ischemia was analyzed by HE staining and confirmed by pathology. Results In the Control group, the center/remote ratio showed no obvious change trend at each time point after reperfusion, while the LV EDV increased gradually over time, and they were significantly negatively correlated (r = − 0.507, p < 0.05). In the Met group, the center/remote ratio gradually increased with time, there was no significant correlation between center/remote ratio and LV EDV (r = − 0.078, p > 0.05). On the 30th day, the center/remote ratio of the Met group was significantly higher than that of the Control group (0.81 ± 0.06 vs. 0.65 ± 0.09, p < 0.05), while LV EDV in Met group was significantly lower than in Control group (358.21 ± 22.62 vs. 457.53 ± 29.91, p < 0.05). There was no significant difference of LVEF between Met group and Control group at different time points after reperfusion (p < 0.05). HE staining showed that the myocardial infarction and fibrosis in ischemic center area of the Control group was more serious than that of the Met group. Conclusions Met could attenuate the severity of MIRI, delay and prevent the progress of LV remodeling. The cardioprotective progress could be dynamically assessed by 18F-FDG micro-PET/CT imaging.

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“…Koroner arter hastalığı (KAH) dünya genelinde mortalite ve morbiditenin önde gelen nedenlerindendir (1) . KAH ilerleyen dönemlerde miyokard infarktüsü (Mİ) ile sonuçlanabilir ki bazı durumlarda Mİ akut dönemde saptanamayabilir.…”

Section: Introductionunclassified

“…İnfarktta ise hem perfüzyon ve kasılma hem metabolizma azalmıştır. İnfarktan farklı olarak, viabl miyokardial dokusu bulunan KAH hastalarına zamanında müdahale yapıldığında miyokardial hasar sınırlandırılıp kontrak-til fonksiyon geri döndürülerek morbidite ve mortalite azaltılabilir (1,6) . F-18 fluoro-2-deoksi-glikoz (FDG) kullanılanarak yapılan PET görüntülemede miyokardiyal metabolizma değerlendirilmektedir.…”

Section: Introductionunclassified

The Value of Tc-99m MIBI Perfusion and 18F-FDG PET Viability Studies in the Evaluation of Coronary Artery Disease

Budak¹,

Yanarateş²

2020

Terh

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Objective: The aim of this study is to compare the findings of Tc-99m MIBI MPS and cardiac F-18 FDG PET with invasive coronary angiography (ICA) and to investigate the value of nuclear cardiac methods in the diagnosis of coronary artery disease (CAD). Method: Seventeen patients who had EKG findings of previously experienced myocardial infarction, and irreversible defect in Tc-99m MIBI MPS and referred to our department for viability evaluation with FDG PET were included in the study. All patients had ICA results. The evaluation was performed on a segmental basis and left ventricular myocardial walls were divided into 5 segments as apex, septum, anterior, lateral and inferior walls. Thus, 85 segments were evaluated in 17 patients. It was accepted that the anterior wall, septum and apex were supplied from the LAD, the inferior wall from the RCA, and the lateral wall from the Cx. Nuclear cardiac methods and ICA findings were compared. Results: Seventeen patients with a mean age of 59.5 years were included in the study. According to the results of ICA, all patients had CAD with ≥ 50% stenosis. MPS was true positive in 67, true negative in 12, false positive in 3, and false negative in 3 segments. The sensitivity, specificity and accuracy of MPS were 95.7%, 80% and 92.9%, respectively. Excellent agrement and high correlation were found between MPS findings and ICA results. When MPS and PET were evaluated together and the segments were grouped; ICA stenosis was significantly lower in segments without perfusion and metabolism defect (normal group) than in segments considered viable or infarct. Conclusion: Tc-99m MIBI MPS and F-18 FDG PET are noninvasive methods having great importance in the evaluation of diagnosis and severity of CAD in the patients with ECG detected unrecognised MI.

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Role of PET-CT in the assessment of myocardial viability in patients with left ventricular dysfunction

Abstract: Viability assessment should be performed in patients who present after 12h of acute myocardial infarction or with LV dysfunction due to ischemic heart disease to decide upon appropriate surgical management.

Cited by 9 publications

References 20 publications

Determination of viable myocardium through delayed enhancement cardiac magnetic resonance imaging combined with 18F-FDG PET myocardial perfusion/metabolic imaging before CABG

Determination of viable myocardium through delayed enhancement cardiac magnetic resonance imaging combined with 18F-FDG PET myocardial perfusion/metabolic imaging before CABG

Evaluating the cardioprotective effect of metformin on myocardial ischemia–reperfusion injury using dynamic 18F-FDG micro-PET/CT imaging

The Value of Tc-99m MIBI Perfusion and 18F-FDG PET Viability Studies in the Evaluation of Coronary Artery Disease

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