Cardiac death in patients with left ventricular aneurysm, remodeling and myocardial viability by gated 99m Tc-MIBI SPECT and gated 18 F-FDG PET

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 (ES VI 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. Pat...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research