Abstract
1647
Objectives: To develop and validate a simple novel method to assess myocardial viability based on the integral analysis of regional myocardial perfusion and myocardial function obtained from gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients with ischemic heart failure.
Methods: One hundred and fifteen consecutive patients with ischemic heart failure who underwent both technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) gated SPECT MPI and 18F-FDG positron emission tomography (PET) myocardial metabolic imaging were enrolled retrospectively. Myocardial perfusion and function polar maps were divided into 17 segments for further analysis. SPECT/PET myocardial viability was defined as the reference standard. The dataset was randomly divided into two cohorts with a ratio of 75% and 25%: developmental and validation cohorts. Regional myocardial perfusion and function indicators were included to create the prediction model of myocardial viability in the developmental cohort. The performance of the model was then assessed in the validation cohort. Results: The developmental and validation cohorts consisted of 86 and 29 patients, respectively. The prediction model had excellent discrimination and calibration with an area under the receiver operating characteristic curve of 0.849 and 0.859, and a non-significant Hosmer-Lemeshow test P = 0.771 and P = 0.813 in the developmental and validation cohorts, respectively. Conclusions: The novel method to assess myocardial viability based on the integral analysis of regional myocardial perfusion and myocardial function obtained from gated SPECT MPI can accurately discriminate hibernating myocardium from scar in patients with ischemic heart failure. Considering wide availability and high cost-effectiveness, it has great promise to become a clinical tool in the assessment of myocardial viability.