PT - JOURNAL ARTICLE AU - Huixing Deng AU - Ji Ting AU - Aimin Yang TI - Assessment of Myocardial Viability and Left Ventricular Function in Patients with Ischemic Cardiomyopathy by Gated DISA Imaging DP - 2017 May 01 TA - Journal of Nuclear Medicine PG - 1188--1188 VI - 58 IP - supplement 1 4099 - http://jnm.snmjournals.org/content/58/supplement_1/1188.short 4100 - http://jnm.snmjournals.org/content/58/supplement_1/1188.full SO - J Nucl Med2017 May 01; 58 AB - 1188Objectives: An important aspect of the diagnosis and prognostic work-up of patients with ischemic cardiomyopathy is the assessment of myocardial viability. Patients with left ventricular dysfunction who have viable myocardium are the patients at highest risk because of the potential for ischemia but at the same time benefit most from revascularization. It is important to identify viable myocardium in these patients, and radionuclide myocardial scintigraphy is an excellent tool for this. The aim of this study was to test the hypothesis that both myocardial viability and LV function can be assessed by a single ECG-gated 18F-FDG/ 99mTc-sestamibi DISA SPECT study, based on comparison with coronary angiography and echocardiogrgaphy as reference techniques.Methods: Thirty-one patients with ischemic cardiomyopathy were studied; all of them were diagnosed by coronary angiography(at least 1 major artery stenosis蠅50%) ; echocardiogrgaphy (LVEF<50%, LVEDD>50mm(female), LVEDD>55mm(male)) and clinical manifestations (left ventricular dysfunction and/or cardiac insufficiency). Patients with normal fasting blood glucose had 300ml milk at 7:00AM as breakfast and 1 hour postprandial blood glucose was measured, after that intravenously injected 99mTc-MIBI 740MBq at resting state. Then their blood glucose was adjusted to 7.9-8.9mmol/L by taking glucose or injecting insulin 4-8u in the subcutaneous tissue, and 18F-FDG 296-370MBq was injected after 30min. 45min later, DISA imaging was performed. For patients with diabetes, the blood glucose was adjusted to about 10mmol/L by subcutaneous injection of insulin 4-20 u, the rest was the same as others. Non-gated DISA imaging was performed in 6 patients with atrial fibrillation, and gated DISA imaging was performed in 25 patients with normal cardiac rhythm. The LV myocardium was divided eight regions, and the perfusion and metabolic core of each region was analyzed by ECTool Box analysis software. The global and regional LVEF measured by gated SPECT was compared with the results of coronary angiography and echocardiogrgaphy.Results: Among the 31 patients, 115 infarcted myocardial segments with a total score of 248 were found by DISA imaging, and 53 segments of them showed myocardial viability by imaging agent reperfusion. The results of ECTool Box showed that the perfusion score was 20.42±8.69 and the metabolic score was 11.84±5.92. Based on the formula: myocardial viability ratio=(perfusion score -metabolic score)/perfusion score, the myocardial viability ratio was 42.07%. The LVEF of 25 patients measured by gated DISA perfusion imaging(15~48%(32.60±11.93)) and gated DISA metabolic imaging(18~51%(35.35±7.38)) was lower than that of echocardiography(24~48%(39.48±10.44)), while there were positive correlations between gated DISA perfusion imaging and echocardiography(R=0.701, P<0.01), and between gated DISA metabolic imaging an echocardiography(R=0.682, P<0.01). The study also showed that perfusion score and metabolic score was negatively correlated with LVEF measured by echocardiography(R=-0.547, P<0.01 and R=-0.401, P=0.025).Conclusion: Gated DISA imaging provides information on myocardial viability in patients with ischemia cardiomyopathy, as well as LV function, and can help clinicians make an appropriate treatment plan. Research Support: this study was supported by National Natural Science Foundation (grant no.2011BAI11B00).