Korean Journal of Radiology

  • 제15권2호
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  • Pages.277-285
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  • 2014
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Impaired Coronary Flow Reserve Is the Most Important Marker of Viable Myocardium in the Myocardial Segment-Based Analysis of Dual-Isotope Gated Myocardial Perfusion Single-Photon Emission Computed Tomography

  • Lee, Won Woo (Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • So, Young (Department of Nuclear Medicine, Konkuk University School of Medicine) ;
  • Kim, Ki-Bong (Department of Thoracic & Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Lee, Dong Soo (Institute of Radiation Medicine, Medical Research Center, Seoul National University)
  • 투고 : 2013.09.18
  • 심사 : 2014.01.14
  • 발행 : 2014.04.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: The aim of this study was to investigate the most robust predictor of myocardial viability among stress/rest reversibility (coronary flow reserve [CFR] impairment), $^{201}Tl$ perfusion status at rest, $^{201}Tl$ 24 hours redistribution and systolic wall thickening of $^{99m}Tc$-methoxyisobutylisonitrile using a dual isotope gated myocardial perfusion single-photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) who were re-vascularized with a coronary artery bypass graft (CABG) surgery. Materials and Methods: A total of 39 patients with CAD was enrolled (34 men and 5 women), aged between 36 and 72 years (mean $58{\pm}8$ standard in years) who underwent both pre- and 3 months post-CABG myocardial SPECT. We analyzed 17 myocardial segments per patient. Perfusion status and wall motion were semi-quantitatively evaluated using a 4-point grading system. Viable myocardium was defined as dysfunctional myocardium which showed wall motion improvement after CABG. Results: The left ventricular ejection fraction (LVEF) significantly increased from $37.8{\pm}9.0%$ to $45.5{\pm}12.3%$ (p < 0.001) in 22 patients who had a pre-CABG LVEF lower than 50%. Among 590 myocardial segments in the re-vascularized area, 115 showed abnormal wall motion before CABG and 73.9% (85 of 115) had wall motion improvement after CABG. In the univariate analysis (n = 115 segments), stress/rest reversibility (p < 0.001) and $^{201}Tl$ rest perfusion status (p = 0.024) were significant predictors of wall motion improvement. However, in multiple logistic regression analysis, stress/rest reversibility alone was a significant predictor for post-CABG wall motion improvement (p < 0.001). Conclusion: Stress/rest reversibility (impaired CFR) during dual-isotope gated myocardial perfusion SPECT was the single most important predictor of wall motion improvement after CABG.

키워드

과제정보

연구 과제 주관 기관 : National Research Foundation (NRF), SNUBH

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