Skip to main content

Advertisement

SpringerLink
Log in

Cardiac death in patients with left ventricular aneurysm, remodeling and myocardial viability by gated 99mTc-MIBI SPECT and gated 18F-FDG PET

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

(1) To evaluate the prognostic value of LV remodeling parameters in patients with LV aneurysm by gated SPECT (GSPECT), gated PET (GPET) and CMR; (2) to evaluate the impact of myocardial viability and LV remodeling on the long-term cardiac survival in patients with LV aneurysm. One hundred and twenty-six consecutive patients underwent GPET, GSPECT and CMR within two weeks, with a mean follow-up of 3.9 ± 1.5 years. End-diastolic volume (EDV, mL) and end-systolic volume (ESV, mL) measured by GPET, GSPECT and CMR and corrected for BSA; EDVI and ESVI were calculated. Patients were divided into three groups by aneurysmal viability [mismatch score (MMS) of aneurysm ≥2.0] and LV remodeling (ESVI by GPET > 60 mL/m2). Group 1 (Viability −, LV remodeling −); Group 2 (Viability −, LV remodeling +) and Group 3 (Viability +, LV remodeling −/+). ESVI by GPET, MMS of aneurysm and summed rest score of aneurysm by multivariate regression analysis; as well as ESVI by GPET (HR 1.024, 95% CI 1.011–1.037, p = .0004), MMS of aneurysm (HR 1.284, 95% CI 1.051–1.577, p = .015) by interaction analysis were approved being independent predictors for cardiac death (p < .05). The long-term cardiac survival was significantly improved by revascularization in comparison with medical therapy in Group3 (p < .01), but did not significantly differ between Groups 1 and 2. ESVI by GPET showed a significant positive predictive value for cardiac death. Patients with viable myocardial aneurysm were most likely at increased risk for cardiac death and coronary revascularization was significantly associated with improved long-term cardiac survival. In contrast, the long-term cardiac survival of patients without LV remodeling and without aneurysmal viability was promising and, thus, could be treated by medical therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Anzai T (2013) Post-infarction inflammation and left ventricular remodeling. Circ J 77:580–587

    Article  CAS  PubMed  Google Scholar 

  2. Mittal S, Aktas MK, Moss AJ, McNitt S, Kutyifa V, Steinberg JS, Zareba W (2014) The impact of nonsustained ventricular tachycardia on reverse remodeling, heart failure, and treated ventricular tachyarrhythmias in MADIT-CRT. J Cardiovasc Electrophysiol 25:1082–1087

    Article  PubMed  Google Scholar 

  3. Heusch G, Libby P, Gersh B, Yellon D, Böhm M, Lopaschuk G, Opie L (2014) Cardiovascular remodelling in coronary artery disease and heart failure. Lancet 383:1933–1943

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Despres JP, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jimenez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB (2016) Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation 133:e38–e360

    Article  PubMed  Google Scholar 

  5. Galli A, Lombardi F (2016) Postinfarct left ventricular remodelling: a prevailing cause of heart failure. Cardiol Res Pract 2016:2579832

    Article  PubMed  PubMed Central  Google Scholar 

  6. Yoshida M, Hirota M, Hoshino J, Kondo T, Isomura T (2015) Prediction of long-term survival in patients with end-stage heart failure secondary to ischemic heart disease: surgical correction and volumetric analysis. Ann Thorac Cardiovasc Surg 21:551–556

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bonow RO, Castelvecchio S, Panza JA, Berman DS, Velazquez EJ, Michler RE, She L, Holly TA, Desvigne-Nickens P, Kosevic D, Rajda M, Chrzanowski L, Deja M, Lee KL, White H, Oh JK, Doenst T, Hill JA, Rouleau JL, Menicanti L, Stich Trial Investigators (2015) Severity of remodeling, myocardial viability, and survival in ischemic LV dysfunction after surgical revascularization. JACC Cardiovasc Imaging 8:1121–1129

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kwon DH, Hachamovitch R, Popovic ZB, Starling RC, Desai MY, Flamm SD, Lytle BW, Marwick TH (2012) Survival in patients with severe ischemic cardiomyopathy undergoing revascularization versus medical therapy: association with end-systolic volume and viability. Circulation 126:S3–S8

    Article  PubMed  Google Scholar 

  9. Anagnostopoulos CD, Cokkinos DV (2011) Prediction of left ventricular remodelling by radionuclide imaging. Eur J Nucl Med Mol Imaging 38:1120–1123

    Article  PubMed  Google Scholar 

  10. Wei H, Tian C, Schindler TH, Qiu M, Lu M, Shen R, Tian Y, Zhao SH, Zhang X (2014) The impacts of severe perfusion defects, akinetic/dyskinetic segments, and viable myocardium on the accuracy of volumes and LVEF measured by gated 99mTc-MIBI SPECT and gated 18F-FDG PET in patients with left ventricular aneurysm: cardiac magnetic resonance imaging as the reference. J Nucl Cardiol 21:1230–1244

    Article  PubMed  Google Scholar 

  11. Lim SP, Mc Ardle BA, Beanlands RS, Hessian RC (2014) Myocardial viability: it is still alive. Semin Nucl Med 44:358–374

    Article  PubMed  Google Scholar 

  12. Zhang X, Liu XJ, Hu S, Schindler TH, Tian Y, He ZX, Gao R, Wu Q, Wei H, Sayre JW, Schelbert HR (2008) Long-term survival of patients with viable and nonviable aneurysms assessed by 99mTc-MIBI SPECT and 18F-FDG PET: a comparative study of medical and surgical treatment. J Nucl Med 49:1288–1298

    Article  PubMed  Google Scholar 

  13. Zhang X, Liu XJ, Wu Q, Shi R, Gao R, Liu Y, Hu S, Tian Y, Guo S, Fang W (2001) Clinical outcome of patients with previous myocardial infarction and left ventricular dysfunction assessed with myocardial 99mTc-MIBI SPECT and 18F-FDG PET. J Nucl Med 42:1166–1173

    CAS  PubMed  Google Scholar 

  14. Holly TA, Abbott BG, Al-Mallah M, Calnon DA, Cohen MC, DiFilippo FP, Ficaro EP, Freeman MR, Hendel RC, Jain D, Leonard SM, Nichols KJ, Polk DM, Soman P (2010) Single photon-emission computed tomography. J Nucl Cardiol 17:941–973

    Article  PubMed  Google Scholar 

  15. Hu YM, Wu XL, Hu ZH, Ren AH, Wei XQ, Wang XC, Yu R (1999) Study of formula for calculating body surface areas of the Chinese adults. Acta Physiol Sin 51:45–48

    CAS  Google Scholar 

  16. Arsanjani R, Berman DS, Gransar H, Cheng VY, Dunning A, Lin FY, Achenbach S, Al-Mallah M, Budoff MJ, Callister TQ, Chang HJ, Cademartiri F, Chinnaiyan KM, Chow BJ, DeLago A, Hadamitzky M, Hausleiter J, Kaufmann P, LaBounty TM, Leipsic J, Raff G, Shaw LJ, Villines TC, Cury RC, Feuchtner G, Kim YJ, Min JK (2014) Left ventricular function and volume with coronary CT angiography improves risk stratification and identification of patients at risk for incident mortality: results from 7758 patients in the prospective multinational CONFIRM observational cohort study. Radiology 273:70–77

    Article  PubMed  Google Scholar 

  17. Oh JK, Velazquez EJ, Menicanti L, Pohost GM, Bonow RO, Lin G, Hellkamp AS, Ferrazzi P, Wos S, Rao V, Berman D, Bochenek A, Cherniavsky A, Rogowski J, Rouleau JL, Lee KL (2013) Influence of baseline left ventricular function on the clinical outcome of surgical ventricular reconstruction in patients with ischaemic cardiomyopathy. Eur Heart J 34:39–47

    Article  PubMed  Google Scholar 

  18. Fernandez SF, Ovchinnikov V, Canty JM Jr, Fallavollita JA (2013) Hibernating myocardium results in partial sympathetic denervation and nerve sprouting. Am J Physiol Heart Circ Physiol 304:H318–H327

    Article  CAS  PubMed  Google Scholar 

  19. Schinkel AF, Bax JJ, Delgado V, Poldermans D, Rahimtoola SH (2010) Clinical relevance of hibernating myocardium in ischemic left ventricular dysfunction. Am J Med 123:978–986

    Article  PubMed  Google Scholar 

  20. Buckberg G, Athanasuleas C, Conte J (2012) Surgical ventricular restoration for the treatment of heart failure. Nat Rev Cardiol 9(12):703–716

    Article  PubMed  Google Scholar 

  21. Jones RH, Velazquez EJ, Michler RE, Sopko G, Oh JK, O’Connor CM, Hill JA, Menicanti L, Sadowski Z, Desvigne-Nickens P, Rouleau JL, Lee KL (2009) Coronary bypass surgery with or without surgical ventricular reconstruction. N Engl J Med 360:1705–1717

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Velazquez EJ, Lee KL, Jones RH, Al-Khalidi HR, Hill JA, Panza JA, Michler RE, Bonow RO, Doenst T, Petrie MC, Oh JK, She L, Moore VL, Desvigne-Nickens P, Sopko G, Rouleau JL (2016) Coronary-artery bypass surgery in patients with ischemic cardiomyopathy. N Engl J Med 374:1511–1520

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This study was funded by Natural Science Foundation of China (Nos. 81571717, 81071177) and Beijing Municipal Science and technology Project (No. Z131107002213181). The authors express their gratitude to Heinrich R Schelbert of his advice and Xinhua Guo of her secretary assistance.

Author information

Author notes

  1. Xiaoli Zhang

    Present address: Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, People’s Republic of China

Authors and Affiliations

  1. Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Bei Lishi Lu, Beijing, 100037, People’s Republic of China

    Weixue Wang, Congna Tian & Xiaoli Zhang

  2. Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria

    Xiang Li & Marcus Hacker

  3. Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People’s Republic of China

    Shihua Zhao

Authors
  1. Weixue Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiang Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Congna Tian
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shihua Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marcus Hacker
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xiaoli Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiaoli Zhang.

Ethics declarations

Conflict of interest

All of authors don’t have any relationship with industry and financial associations from within the past 3 years that might pose a conflict of interest in connection with the submitted article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, W., Li, X., Tian, C. et al. Cardiac death in patients with left ventricular aneurysm, remodeling and myocardial viability by gated 99mTc-MIBI SPECT and gated 18F-FDG PET. Int J Cardiovasc Imaging 34, 485–493 (2018). https://doi.org/10.1007/s10554-017-1234-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-017-1234-8

Keywords

Search

Navigation