PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, China.
Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou, China.
Jpn J Radiol. 2024 Nov;42(11):1270-1279. doi: 10.1007/s11604-024-01611-6. Epub 2024 Jun 10.
Myocardial viability evaluation in predicting survival after coronary artery bypass graft (CABG) remains debatable. Thus, this study aimed to investigate the role of N-NH/F-FDG PET myocardial viability scan in predicting treatment outcomes and survival.
90 patients with CABG and pre-surgical PET-based myocardial viability scan were retrospectively reviewed. Perfusion-metabolism features, myocardium motion parameters, and patient characteristics were recorded. Additionally, the SUVmean of blood pool, lung, liver, spleen, and muscle were measured and the SUVmean ratios were calculated. Factors associated with treatment outcomes and survival were analyzed by Logistic and Cox regressions. Nomogram models were subsequently established to predict ejection fraction (EF) improvement and survival outcomes.
The mean EF of these 90 patients was 38.1 ± 9.5% and 46.0 ± 9.2% before and after CABG surgery, and 35 patients (38.9%) achieved EF improvement ≥ 10%. EF measurements by PET and echocardiogram showed a reasonable linear correlation (R = 0.752). Sex, pre-surgical EF, mismatch of the left ventricle, total perfusion deficit (TPD), and peak ejection rate (PER) were independent predictive factors of EF improvements. Surgery waiting time, valve damage, and SUVmean ratio of Liver/Muscle were independently predictive of event-free survival (EFS), while valve damage, together with SUVmean ratio of either Liver/Muscle or Lung/Muscle, were independently predictive of overall survival (OS).
Although traditional cardiac parameters from PET-based myocardial viability can effectively predict EF improvements after CABG, SUVmean ratios of liver/muscle and lung/muscle from N-NH PET perfusion outperformed these parameters in predicting survival.
冠状动脉旁路移植术（CABG）后心肌存活能力的评估仍存在争议。因此，本研究旨在探讨 N-NH/F-FDG PET 心肌存活扫描在预测治疗结果和生存中的作用。
回顾性分析 90 例行 CABG 术和术前 PET 心肌存活扫描的患者。记录灌注-代谢特征、心肌运动参数和患者特征。此外，测量血池、肺、肝、脾和肌肉的 SUVmean，并计算 SUVmean 比值。通过 Logistic 和 Cox 回归分析与治疗结果和生存相关的因素。随后建立列线图模型预测射血分数（EF）改善和生存结局。
90 例患者的平均 EF 在 CABG 术前和术后分别为 38.1±9.5%和 46.0±9.2%，35 例（38.9%）EF 改善≥10%。PET 和超声心动图测量的 EF 之间存在良好的线性相关性（R=0.752）。性别、术前 EF、左心室失配、总灌注缺损（TPD）和峰值射血率（PER）是 EF 改善的独立预测因素。手术等待时间、瓣膜损伤和肝脏/肌肉 SUVmean 比值是无事件生存（EFS）的独立预测因素，而瓣膜损伤与肝脏/肌肉或肺/肌肉的 SUVmean 比值共同是总生存（OS）的独立预测因素。
尽管基于 PET 的心肌存活的传统心脏参数可有效预测 CABG 后 EF 的改善，但来自 N-NH PET 灌注的肝脏/肌肉和肺/肌肉 SUVmean 比值在预测生存方面优于这些参数。
