Cardiac death in patients with left ventricular aneurysm, remodeling and myocardial viability by gated 99mTc-MIBI SPECT and gated 18F-FDG PET.
Int J Cardiovasc Imaging
; 34(3): 485-493, 2018 Mar.
Article
in En
| MEDLINE
| ID: mdl-28823060
ABSTRACT
(1) To evaluate the prognostic value of LV remodeling parameters in patients with LV aneurysm by gated SPECT (GSPECT), gated PET (GPET) and CMR; (2) to evaluate the impact of myocardial viability and LV remodeling on the long-term cardiac survival in patients with LV aneurysm. One hundred and twenty-six consecutive patients underwent GPET, GSPECT and CMR within two weeks, with a mean follow-up of 3.9 ± 1.5 years. End-diastolic volume (EDV, mL) and end-systolic volume (ESV, mL) measured by GPET, GSPECT and CMR and corrected for BSA; EDVI and ESVI were calculated. Patients were divided into three groups by aneurysmal viability [mismatch score (MMS) of aneurysm ≥2.0] and LV remodeling (ESVI by GPET > 60 mL/m2). Group 1 (Viability -, LV remodeling -); Group 2 (Viability -, LV remodeling +) and Group 3 (Viability +, LV remodeling -/+). ESVI by GPET, MMS of aneurysm and summed rest score of aneurysm by multivariate regression analysis; as well as ESVI by GPET (HR 1.024, 95% CI 1.011-1.037, p = .0004), MMS of aneurysm (HR 1.284, 95% CI 1.051-1.577, p = .015) by interaction analysis were approved being independent predictors for cardiac death (p < .05). The long-term cardiac survival was significantly improved by revascularization in comparison with medical therapy in Group3 (p < .01), but did not significantly differ between Groups 1 and 2. ESVI by GPET showed a significant positive predictive value for cardiac death. Patients with viable myocardial aneurysm were most likely at increased risk for cardiac death and coronary revascularization was significantly associated with improved long-term cardiac survival. In contrast, the long-term cardiac survival of patients without LV remodeling and without aneurysmal viability was promising and, thus, could be treated by medical therapy.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tomography, Emission-Computed, Single-Photon
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Ventricular Function, Left
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Technetium Tc 99m Sestamibi
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Radiopharmaceuticals
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Fluorodeoxyglucose F18
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Ventricular Remodeling
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Positron-Emission Tomography
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Cardiac-Gated Imaging Techniques
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Heart Aneurysm
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Myocardium
Type of study:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Int J Cardiovasc Imaging
Journal subject:
DIAGNOSTICO POR IMAGEM
Year:
2018
Document type:
Article