Top

The International Journal of Cardiovascular Imaging

Published in:

Open Access 24-01-2024 | CABG | Original Paper

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

Authors: Dongsheng Xu, Jiwang Zhang, Bing Liu, Donghai Fu, Jianming Li, Lijuan Fan

Published in: The International Journal of Cardiovascular Imaging | Issue 4/2024

Abstract

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.

Sun LY, Gaudino M, Chen RJ, Bader Eddeen A, Ruel M (2020) Long-term outcomes in patients with severely reduced left ventricular ejection Fraction undergoing percutaneous coronary intervention vs coronary artery bypass grafting. JAMA Cardiol 5:631–641. https://doi.org/10.1001/jamacardio.2020.0239CrossRefPubMedPubMedCentral

Tsuneyoshi H, Komiya T, Kadota K et al (2017) Coronary artery bypass surgery is superior to second generation drug-eluting stents in three-vessel coronary artery disease: a propensity score matched analysis. Eur J cardio-thoracic Surgery: Official J Eur Association Cardio-thoracic Surg 52:462–468. https://doi.org/10.1093/ejcts/ezx031CrossRef

Fang HY, Fang YN, Chen YC, Sheu JJ, Lee WC (2023) The Impact of Complete Revascularization in Symptomatic Severe Left Ventricular Dysfunction between Coronary Artery Bypass Graft and Percutaneous Coronary Intervention. Cardiology research and practice 2023: 9226722. https://doi.org/10.1155/2023/9226722

Gerber BL, Rousseau MF, Ahn SA et al (2012) Prognostic value of myocardial viability by delayed-enhanced magnetic resonance in patients with coronary artery disease and low ejection fraction: impact of revascularization therapy. J Am Coll Cardiol 59:825–835. https://doi.org/10.1016/j.jacc.2011.09.073CrossRefPubMed

Allman KC, Shaw LJ, Hachamovitch R, Udelson JE (2002) Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. J Am Coll Cardiol 39:1151–1158. https://doi.org/10.1016/s0735-1097(02)01726-6CrossRefPubMed

Katikireddy CK, Samim A (2022) Myocardial viability assessment and utility in contemporary management of ischemic cardiomyopathy. Clin Cardiol 45:152–161. https://doi.org/10.1002/clc.23779CrossRefPubMedPubMedCentral

Sharma VJ, Arghami A, Pasupula DK, Haddad A, Ke JXC (2022) Outcomes of coronary artery bypass grafting in patients with poor myocardial viability: a systematic review and Meta-analysis of the last decade. Heart Lung Circ 31:916–923. https://doi.org/10.1016/j.hlc.2021.12.016CrossRefPubMed

Srivatsava MK, Indirani M, Sathyamurthy I, Sengottuvelu G, Jain AS, Shelley S (2016) Role of PET-CT in the assessment of myocardial viability in patients with left ventricular dysfunction. Indian Heart J 68:693–699. https://doi.org/10.1016/j.ihj.2015.11.017CrossRefPubMedPubMedCentral

Wang L, Lu MJ, Feng L et al (2019) Relationship of myocardial hibernation, scar, and angiographic collateral flow in ischemic cardiomyopathy with coronary chronic total occlusion. J Nuclear Cardiology: Official Publication Am Soc Nuclear Cardiol 26:1720–1730. https://doi.org/10.1007/s12350-018-1241-8CrossRef

10.

Rischpler C, Langwieser N, Souvatzoglou M et al (2015) PET/MRI early after myocardial infarction: evaluation of viability with late gadolinium enhancement transmurality vs. 18F-FDG uptake. Eur Heart J Cardiovasc Imaging 16:661–669. https://doi.org/10.1093/ehjci/jeu317CrossRefPubMed

11.

Wu YW, Tadamura E, Yamamuro M et al (2007) Comparison of contrast-enhanced MRI with (18)F-FDG PET/201Tl SPECT in dysfunctional myocardium: relation to early functional outcome after surgical revascularization in chronic ischemic heart disease. J Nuclear Medicine: Official Publication Soc Nuclear Med 48:1096–1103. https://doi.org/10.2967/jnumed.106.038596CrossRef

12.

Roes SD, Kaandorp TA, Marsan NA et al (2009) Agreement and disagreement between contrast-enhanced magnetic resonance imaging and nuclear imaging for assessment of myocardial viability. Eur J Nucl Med Mol Imaging 36:594–601. https://doi.org/10.1007/s00259-008-1001-0CrossRefPubMed

13.

Adhaduk M, Paudel B, Liu K et al (2023) Comparison of cardiac magnetic resonance imaging and fluorodeoxyglucose positron emission tomography in the assessment of myocardial viability: meta-analysis and systematic review. J Nuclear Cardiol 30:2514–2524. https://doi.org/10.1007/s12350-023-03377-2CrossRef

14.

Bingham SE, Hachamovitch R (2011) Incremental prognostic significance of combined cardiac magnetic resonance imaging, adenosine stress perfusion, delayed enhancement, and left ventricular function over preimaging information for the prediction of adverse events. Circulation 123:1509–1518. https://doi.org/10.1161/circulationaha.109.907659CrossRefPubMed

15.

Ripley DP, Gosling OE, Bhatia L et al (2014) The relationship between the contralateral collateral supply and myocardial viability on cardiovascular magnetic resonance: can the angiogram predict functional recovery? Int J Cardiol 177:362–367. https://doi.org/10.1016/j.ijcard.2014.06.048CrossRefPubMed

16.

Cerqueira MD, Weissman NJ, Dilsizian V et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Int J Cardiovasc Imaging 18:539–542PubMed

17.

Kelle S, Roes SD, Klein C et al (2009) Prognostic value of myocardial infarct size and contractile reserve using magnetic resonance imaging. J Am Coll Cardiol 54:1770–1777. https://doi.org/10.1016/j.jacc.2009.07.027CrossRefPubMed

18.

Dilsizian V (2016) Highlights from the updated joint ASNC/SNMMI PET myocardial perfusion and metabolism clinical imaging guidelines. Journal of nuclear medicine: official publication. Soc Nuclear Med 57:1327–1328. https://doi.org/10.2967/jnumed.116.176214CrossRef

19.

Schinkel AF, Poldermans D, Elhendy A, Bax JJ (2007) Assessment of myocardial viability in patients with heart failure. J Nuclear Medicine: Official Publication Soc Nuclear Med 48:1135–1146. https://doi.org/10.2967/jnumed.106.038851CrossRef

20.

Schinkel AF, Poldermans D, Rizzello V et al (2004) Why do patients with ischemic cardiomyopathy and a substantial amount of viable myocardium not always recover in function after revascularization? J Thorac Cardiovasc Surg 127:385–390. https://doi.org/10.1016/j.jtcvs.2003.08.005CrossRefPubMed

21.

Partington SL, Kwong RY, Dorbala S (2011) Multimodality imaging in the assessment of myocardial viability. Heart Fail Rev 16:381–395. https://doi.org/10.1007/s10741-010-9201-7CrossRefPubMedPubMedCentral

22.

Bondarenko O, Beek AM, Twisk JW, Visser CA, van Rossum AC (2008) Time course of functional recovery after revascularization of hibernating myocardium: a contrast-enhanced cardiovascular magnetic resonance study. Eur Heart J 29:2000–2005. https://doi.org/10.1093/eurheartj/ehn266CrossRefPubMed

23.

Samady H, Elefteriades JA, Abbott BG, Mattera JA, McPherson CA, Wackers FJ (1999) Failure to improve left ventricular function after coronary revascularization for ischemic cardiomyopathy is not associated with worse outcome. Circulation 100:1298–1304. https://doi.org/10.1161/01.cir.100.12.1298CrossRefPubMed

24.

Bonow RO, Maurer G, Lee KL et al (2011) Myocardial viability and survival in ischemic left ventricular dysfunction. N Engl J Med 364:1617–1625. https://doi.org/10.1056/NEJMoa1100358CrossRefPubMedPubMedCentral

25.

Di Carli MF, Hachamovitch R, Berman DS (2002) The art and science of predicting postrevascularization improvement in left ventricular (LV) function in patients with severely depressed LV function. J Am Coll Cardiol 40:1744–1747. https://doi.org/10.1016/s0735-1097(02)02498-1CrossRefPubMed

26.

Kiko T, Yokokawa T, Misaka T et al (2021) Myocardial viability with chronic total occlusion assessed by hybrid positron emission tomography/magnetic resonance imaging. J Nuclear Cardiol 28:2335–2342. https://doi.org/10.1007/s12350-020-02041-3CrossRef

27.

Kühl HP, Lipke CS, Krombach GA et al (2006) Assessment of reversible myocardial dysfunction in chronic ischaemic heart disease: comparison of contrast-enhanced cardiovascular magnetic resonance and a combined positron emission tomography-single photon emission computed tomography imaging protocol. Eur Heart J 27:846–853. https://doi.org/10.1093/eurheartj/ehi747CrossRefPubMed

28.

Babes EE, Tit DM, Bungau AF et al (2022) Myocardial viability testing in the management of ischemic heart failure. Life (Basel Switzerland) 12:1760. https://doi.org/10.3390/life12111760CrossRefPubMed

Title: Determination of viable myocardium through delayed enhancement cardiac magnetic resonance imaging combined with 18F-FDG PET myocardial perfusion/metabolic imaging before CABG
Authors: Dongsheng Xu
Jiwang Zhang
Bing Liu
Donghai Fu
Jianming Li
Lijuan Fan
Publication date: 24-01-2024
Publisher: Springer Netherlands
Keywords: CABG
CABG
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: The International Journal of Cardiovascular Imaging / Issue 4/2024
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-024-03057-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2024

Photon-counting CT-angiography in pre-TAVR aortic annulus assessment: effects of retrospective vs. prospective ECG-synchronization on prosthesis valve selection

Cardiac magnetic resonance-derived mitral annular plane systolic excursion: a robust indicator for risk stratification after myocardial infarction

Prognostic value of visual and quantitative CMR regional myocardial function in patients with suspected myocarditis

Halved contrast medium dose coronary dual-layer CT-angiography – phantom study of tube current and patient characteristics

Virtual non-contrast series of photon-counting detector computed tomography angiography for aortic valve calcium scoring

Longitudinal strain and myocardial work in symptomatic patients having recovered from COVID-19 and possible associations with the severity of the disease