RT Journal Article SR Electronic T1 Impact of Diabetes Mellitus on Prediction of Clinical Outcome After Coronary Revascularization by 18F-FDG SPECT in Patients with Ischemic Left Ventricular Dysfunction JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 68 OP 73 VO 47 IS 1 A1 Arend F.L. Schinkel A1 Don Poldermans A1 Vittoria Rizzello A1 Ron T. van Domburg A1 Roelf Valkema A1 Abdou Elhendy A1 Elena Biagini A1 Eric P. Krenning A1 Maarten L. Simoons A1 Jeroen J. Bax YR 2006 UL http://jnm.snmjournals.org/content/47/1/68.abstract AB Nuclear imaging using 18F-FDG is an established method for the noninvasive assessment of myocardial viability. Data on the value of 18F-FDG imaging in patients with diabetes mellitus are scarce. The aim of this study was to assess whether, in patients with diabetes mellitus and ischemic left ventricular (LV) dysfunction, 18F-FDG imaging can predict improvement of LV function and heart failure symptoms after coronary revascularization. Methods: A total of 130 consecutive patients with ischemic LV dysfunction who were already scheduled for surgical revascularization were studied; 34 of the patients had diabetes mellitus. All patients underwent radionuclide ventriculography to assess left ventricular ejection fraction (LVEF), resting 2-dimensional echocardiography to identify dysfunctional myocardial tissue, and dual-isotope 18F-FDG/99mTc-tetrofosmin SPECT after oral administration of acipimox. Nine to 12 mo after coronary revascularization, radionuclide ventriculography and echocardiography were repeated. An improvement in LVEF by at least 5% was considered significant. Results: 18F-FDG SPECT demonstrated that 610 (50%) of 1,212 dysfunctional segments were viable. Patients with and without diabetes mellitus had a comparable number of dysfunctional but viable segments per patient. Also, the number of patients with a substantial amount of dysfunctional but viable myocardium (≥4 viable segments) was comparable between the groups with and without diabetes mellitus. The presence of substantial viability on 18F-FDG SPECT was predictive of improvement in LVEF and heart failure symptoms postoperatively (sensitivity and specificity of 82% and 89%, respectively, in patients with diabetes and 83% and 93%, respectively, in patients without diabetes; not statistically significant). Conclusion: 18F-FDG SPECT is practical for routine assessment of myocardial viability in patients with ischemic LV dysfunction with or without diabetes mellitus. Patients with substantial myocardial viability on 18F-FDG SPECT have a high probability of improvement of LV function and symptoms after coronary revascularization, irrespective of the absence or presence of diabetes mellitus.