Prevalence of myocardial viability in left ventricular aneurysm assessed by 99mTc-MIBI SPECT and 18F-FDG PET and the related parameters

Objectives Our previous investigation reported the prognostic value of myocardial viability assessment on patients with left ventricular aneurysm (LVA). However, the prevalence of myocardial viability in patients with acute myocardial infarction (AMI) and previous myocardial infraction is unknown. Our purpose is to analyze the prevalence of myocardial viability in a relative large group with LVA and further, to explore the parameters influenced myocardial viability in LVA.

Methods One hundred and ninety-seven consecutive patients (mean age, 59±10 years; 174 men; mean EF, 38.89±7.765%) with MI and evidence of LVA by UCG/MRI who performed 99mTc-MIBI SPECT and 18F-FDG PET were enrolled retrospectively. There were 49 pts with AMI and 148 pts with OMI. Myocardial viability in aneurysms, peripheral and remote LVA regions was visually analyzed and defined as perfusion/metabolism mismatch score of 2.0 or greater with a 17-segment model, respectively. Then, patients were classified into 3 subgroups: nonviable LVA, viable LVA and viable in peripheral and/or remote aneurismal regions. Further, we explore the correlation between clinical and imaging parameters and myocardial viability in aneurysm by logistic regression analysis.

Results In AMI group, 14 (28.6%) pts had nonviable LVA and 12 (24.5%) had viable LVA. Similarly, in OMI group, 52 (35.1%) pts had nonviable LVA, and 32 (21.6%) had viable LVA. There were no statistical differences between AMI group and OMI group in terms of LVA viability (χ2=0.72, P=0.697). Logistic regression analysis revealed that diverged of SPECT image (χ2=11.51, P=0.03) and previous PTCA (χ2=13.02, P=0.001) were associated with myocardial viability in aneurysm.

Conclusions The prevalence of myocardial viability in a special group with LVA had no significant difference between patients with AMI and previous MI.