The Value of Myocardium Perfusion Imaging in Assessment of Patients With Ischemic Cardiomyopathy

Шипулин, В. М.; Саушкин, В. В.; Pryakhin, A. S.; Андреев, С. Л.; Vesnina, Zh. V.; Zavadovsky, Konstantin

doi:10.21569/2222-7415-2019-9-3-155-175

Cited by 7 publications

(5 citation statements)

References 28 publications

(34 reference statements)

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“…Наличие сократительного резерва, по данным ЭхоКГ, обладает чувствительностью 57% и специфичностью 73% в аспекте восстановления сократительной функции ЛЖ после реваскуляризации [1,2]. В то же время повышенные значения диссинхронии ассоциированы с риском развития повторного ремоделирования и худшим прогнозом у данной группы пациентов [9].…”

Section: Discussionunclassified

“…Хирургическое лечение ишемической кардиомиопатии (ИКМП), включающее максимальную реваскуляризацию, реконструкцию полости левого желудочка (ЛЖ) и пластику митрального клапана, имеет преимущество перед консервативной терапией [1][2][3]. Однако у части пациентов в отдаленном периоде после оперативного лечения наблюдается повторное ремоделирование ЛЖ [3], что ассоциировано с неблагоприятным прогнозом [4].…”

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“…Наличие сократительного резерва -известный прогностический критерий восстановления функции миокарда после реваскуляризации [2]. Радионуклидная томовентрикулография (РТВГ) сопоставима с магнитно-резонансной томографией в аспекте точности определения объемов и сократительной функции желудочков сердца, а также с трехмерной эхокардиографией (ЭхоКГ) в оценке механической диссинхронии ЛЖ [5].…”

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Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

et al. 2020

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Aim. To assess the potential of stress tomographic radionuclide ventriculography (T-RVG) in long-term prognosis of left ventricular (LV) re-remodeling after surgery of ischemic cardiomyopathy.Material and methods. Thirty patients with ischemic cardiomyopathy, before surgical treatment, underwent resting T-RVG and with increasing doses of dopamine (5/10/15 pg/kg/min (5 min/dose). All patients underwent two-dimensional echocardiography before surgery, in the short- (7-14 days) and long-term postoperative period. In the long-term postoperative period (476±36 days), the patients were divided into two groups: group 1 (n=19) — patients with ongoing LV remodeling (increase in the LV end-systolic volume (ESV) or decrease <10% relatively short-term postoperative period), group 2 (n=11) — patients with decreased LV ESV >10%.Results. The results revealed significant differences between the groups in the dynamics (Δ) of the LV ejection fraction (EF) (%) (2 (2;8); 11 (5;12), p=0,02), peak ejection rate (%) (32 (14;51); 63 (34;79), p=0,009), LV dyssynchrony (PSDo (3 (0;7); -2 (-9;3), p=0,004); Entropy (%) (2 (-1;6); 0 (-4;2), p=0,01)). Univariate regression showed that ΔLVEF (odds ratio (OR), 0,88; confidence interval (CI), 0,8; 0,97; p=0.008), ΔLVPSD (OR, 1,13; CI, 1,03; 1,25; p=0,005), and coronary stenosis >75% (OR, 4,25; CI, 1,57; 11,48; p=0,001) had a predictive value. According to the ROC-analysis, the sensitivity, specificity, and AUC were 87%, 64% and 0,727 for ΔLVPSD (threshold >-1); 84%, 46% and 0,691 for coronary stenosis >75% >75% (threshold >2); 65%, 82% and 0,674 for ΔLVEF (threshold ≤4), respectively. The logistic model, which included these parameters and the presence of diabetes, showed a significantly greater AUC (0,907, p<0,05) compared with these indicators taken separately.Conclusion. Preoperative values of ΔLVEF and ΔLVPSD obtained with stress T-RVG have prognostic significance in relation to LV long-term re-remodeling.

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Section: Discussionunclassified

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Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

et al. 2020

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“…Myocardial perfusion was assessed globally and for LAD region by following parameters: summed stress score (SSS), summed rest scores (SRS), summed difference score (SDS, difference between SSS and SRS), total perfusion defecate (TPD) at stress and at rest [19,[26][27][28][29].…”

Section: Mpi Interpretationmentioning

confidence: 99%

“…Alas, only 29% of patients underwent preoperative SPECT-MPI in that study [2]. Moreover, preoperative myocardial perfusion imaging can provide clinicians with vital information about coronary vessel perfusion area, including extent of scar and ischemia [19]. This study aimed to assess the association between preoperative myocardial perfusion data with transit time blood flow characteristics in left internal mammary artery to left anterior descending artery grafts in patients with ischemic cardiomyopathy.…”

Section: Introductionmentioning

confidence: 99%

The preoperative myocardial perfusion and internal mammary artery graft blood flow relationship in patients with ischemic cardiomyopathy

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Андреев

Мочула

et al. 2023

Medicinskaâ vizualizaciâ

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Objective. The purpose of this study was to determine the association between preoperative myocardial perfusion data (obtained by SPECT) with transit time blood flow characteristics in left internal mammary artery (LIMA) to left anterior descending artery (LAD) grafts in patients with ischemic cardiomyopathy.Methods. The study group consisted of 57 patients with ischemic cardiomyopathy. Intraoperative transit-time flow measurement (TTFM) of LIMA-LAD grafts were performed in all patients. All patients were also examined with preoperative stress and rest myocardial perfusion SPECT with 99m Tc-MIBI. Anastomotic patency was considered satisfactory with a normal waveform of blood flow, diastolic-dominant blood filling, and a mean flow value greater than 11.5 ml/min.Results. All 57 patients with LIMA-LAD grafts were divided into two groups; those with graft satisfactory patency (n = 40) and those with unsatisfactory patency (n = 17) as determined by TTFM. We found differences among these groups in values of global summed rest score (20.7 ± 7.5 vs. 29.8 ± 4.0; p = 0.002), global total perfusion deficit (TPD) at rest (32.0 ± 11.4 vs. 43.0 ± 7.2; p = 0.01), and regional TPD at rest in the LAD territory (20.7 ± 7.5 vs. 29.8 ± 4.0; p = 0.002). Additionally, the flow characteristics were different in patients with and without surgical left ventricle reconstruction (Q (ml/min): 17 (11.5, 40.8) vs. 47 (25, 69.5), p = 0.013; PI: 3.9 (3.2, 7.4) vs. 2.4 (2.0, 3.6), p = 0.001; DF (%): 63.5 (44.5, 70.8) vs. 74 (66.0, 79.7), p = 0.019). TPD at rest was the best predictor of the LIMA-LAD graft satisfactory: area under curve = 0.771, cut-off value = 26.85 with 83.3% sensitivity and 78.1% specificity.Conclusions. Preoperative myocardial perfusion characteristics are associated with blood flow in LIMA-LAD graft in patients with ischemic cardiomyopathy. TPD at rest (assessed globally and in the LAD region) as well as global SRS value are potential predictors of early graft failure.

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Combined myocardial perfusion scintigraphy and computed tomography: diagnostic and prognostic value in coronary artery disease

et al. 2022

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Modern imaging techniques occupy an important place in the diagnosis, selection of treatment and prognosis of patients with coronary artery disease. Hybrid imaging is a combination of two sets of diagnostic data that complement and enhance each other by comparing anatomical and functional characteristics. As a rule, hybrid imaging is synergistic, that is, more powerful, since the addition of new information leads to an increase in the sensitivity and specificity of each of the modalities separately.The review provides brief information on the diagnostic efficacy of myocardial perfusion scintigraphy (MPS), computerized tomography (CT) coronary angiography in comparison with invasive coronary angiography with fractional flow reserve. The diagnostic and prognostic significance of assessing calcium index with MPS, as well as CT coronary angiography combined with MPS in the diagnosis, risk stratification and prognosis of patients with coronary artery disease, is characterized in detail. A separate section is devoted to the importance of hybrid imaging in making decisions about myocardial revascularization.

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The Value of Myocardium Perfusion Imaging in Assessment of Patients With Ischemic Cardiomyopathy

Cited by 7 publications

References 28 publications

Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

The preoperative myocardial perfusion and internal mammary artery graft blood flow relationship in patients with ischemic cardiomyopathy

Combined myocardial perfusion scintigraphy and computed tomography: diagnostic and prognostic value in coronary artery disease

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