Srivatsava Madhur Kumar, Indirani M, Sathyamurthy I, Sengottuvelu G, Jain Avani S, Shelley S
Consultant, Nuclear Medicine and PET-CT, Yashoda Hospital, Hyderabad, India.
Department of Nuclear Medicine and PET-CT, Apollo Main Hospital, Chennai, India.
Indian Heart J. 2016 Sep-Oct;68(5):693-699. doi: 10.1016/j.ihj.2015.11.017. Epub 2016 Jan 11.
Role of PET-CT in assessment of myocardial viability in patients with LV dysfunction.
This prospective study included 120 patients with LV dysfunction who underwent 99mTechnetium-Sestamibi myocardial perfusion SPECT-CT and 18FFDG cardiac PET-CT. They also underwent serial echocardiography and coronary angiography along with myocardial perfusion and FDG PET study.
Thirty-three patients had single vessel disease, 48 had triple vessel disease, and rest had double vessel disease. Among 786 segments, matched defects were seen in 432 (55%) and mismatched defects in 354 (45%) segments. 78 patients were surgically managed, and 42 were medically managed. The change in LVEF after surgical management was statistically significant compared to medical management.
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.
探讨PET-CT在评估左心室功能不全患者心肌存活性中的作用。
本前瞻性研究纳入了120例左心室功能不全患者,这些患者接受了99m锝- sestamibi心肌灌注SPECT-CT和18F-FDG心脏PET-CT检查。他们还接受了系列超声心动图、冠状动脉造影以及心肌灌注和FDG PET研究。
33例患者为单支血管病变,48例为三支血管病变,其余为双支血管病变。在786个节段中,432个(55%)节段出现匹配性缺损,354个(45%)节段出现不匹配性缺损。78例患者接受了手术治疗,42例接受了药物治疗。与药物治疗相比,手术治疗后左心室射血分数的变化具有统计学意义。
对于急性心肌梗死后12小时以上就诊或因缺血性心脏病导致左心室功能不全的患者,应进行存活性评估,以决定合适的手术治疗方案。