Comparison of prognostic value of (18)F-FDG PET/CT myocardial metabolism imaging and coronary collateral circulation in patients with CTO lesions

Abstract

Objective: To evaluate the location, extent of viable myocardial of chronic total coronary occlusions(CTO)lesions by (18)F-FDG PET myocardial metabolism imaging and then compare with coronary collateral circulation(CCC) to evaluate the prognostic evaluation in patients with CTO lesions. Methods: A total of Sixty consecutive patients with CTO lesions referred for viability assessment from April 2016 to April 2017 in Department of Cardiology, Beijing Anzhen Hospital were included in the study. These patients underwent (99m)Tc-sestamibi ECG-gated SPECT rest myocardial perfusion imaging and ECG-gated (18)F-FDG PET/CT myocardial metabolic imaging, as well as coronary arteriography were recruited in this study. LV functional parameters(EDV, ESV, and LVEF) were analyzed by QGS software. The extent of CCC to the area of CTO related artery was graded as poorly, or well developed collaterals, assessed by Rentrop classification. All patients were followed up for a median of 17 months(range 12-20 months) and evaluated the changes of NYHA. Then the prognostic value of (18)F-FDG PET myocardial metabolism imaging and CCC in patients with CTO lesions were analyzed and evaluated. Results: As the standard evaluation of NYHA in patients with CTO lesions after 12-20 months, fifty-three patients were assigned in this study. According to the changes of NYHA, the patients were divided into no progress group and progress group. There were no statistically difference in age, gender, high risk of CTO lesion and drugs in two groups, but there were significant statistical differences in myocardial parameters. LVEF was significantly increased in patients with CTO lesion in no progress group(42.3%±17.2% vs 22.2%±10.4%, P<0.01). The EDV and ESV in no progress group were significantly smaller than patients in progress group.The sensitivity(95.2% vs 75.7%) and specificity(62.8% vs 38.1%) of (18)F-FDG PET myocardial metabolism imaging was much better than CCC in the evaluation of prognosis in patients with CTO lesion. Conclusion: (18)F-FDG PET myocardial metabolism imaging has important role in the prognosis of patient with CTO lesions when compared with CCC.