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KMID : 0191120230380460399
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Journal of Korean Medical Science
2023 Volume.38 No. 46 p.399 ~ p.399
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Impact of Positron Emission Tomography Viability Imaging: Guided Revascularizations on Clinical Outcomes in Patients With Myocardial Scar on Single-Photon Emission Computed Tomography Scans
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Park Jong-Sung
Lee Jang-Hoon
Hong Chae-Moon
Park Bo-Eun
Park Yoon-Jung
Kim Hong-Nyun
Kim Nam-Kyun
Jang Se-Yong
Bae Myung-Hwan
Yang Dong-Heon
Park Hun-Sik
Cho Yong-Keun
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Abstract
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Background : Positron emission tomography (PET) viability scan is used to determine whether patients with a myocardial scar on single-photon emission computed tomography (SPECT) may need revascularization. However, the clinical utility of revascularization decision-making guided by PET viability imaging has not been proven yet. The purpose of this study was to investigate the impact of PET to determine revascularization on clinical outcomes.
Methods : Between September 2012 and May 2021, 53 patients (37 males; mean age = 64 ± 11 years) with a myocardial scar on MIBI SPECT who underwent PET viability test were analyzed in this study. The primary outcome was a temporal change in echocardiographic findings. The secondary outcome was all-cause mortality.
Results : Viable myocardium was presented by PET imaging in 29 (54.7%) patients. Revascularization was performed in 26 (49.1%) patients, including 18 (34.0%) with percutaneous coronary intervention (PCI) and 8 (15.1%) with coronary artery bypass grafting. There were significant improvements in echocardiographic findings in the revascularization group and the viable myocardium group. All-cause mortality was significantly lower in the revascularization group than in the medical therapy-alone group (19.2% vs. 44.4%, log-rank P = 0.002) irrespective of viable (21.4% vs. 46.7%, log-rank P = 0.025) or non-viable myocardium (16.7% vs. 41.7%, log-rank P = 0.046). All-cause mortality was significantly lower in the PCI group than in the medical therapy-alone group (11.1% vs. 44.4%, log-rank P < 0.001).
Conclusion : Revascularization improved left ventricular systolic function and survival of patients with a myocardial scar on SPECT scans, irrespective of myocardial viability on PET scans.
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KEYWORD
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Myocardial Scar, Positron Emission Tomography, Single-Photon Emission Computed Tomography, Revascularization, Percutaneous Coronary Intervention, Prognosis
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