Myocardial viability in patients with ischemic cardiomyopathy— evaluation by 3-D integration of myocardial scintigraphic data—and coronary angiographic data

Abstract

Purpose To determine the prevalence of viable myocardium in patients with ischemic cardiomyopathy and, to evaluate the value of three-dimensional (3-D) fusion imaging of myocardial scintigraphic and angiographic data to assign coronary artery lesions to the corresponding viable and nonviable myocardial territory. Procedures In 105 patients, the combination of perfusion and metabolic imaging with 201thallium ( 201TI) single-photon emission computed tomography (SPECT) and 2-deoxy-2-[ 18F]fluoro-D-glucose (FDG) positron emission tomography (PET) determined viability in dysfunctional myocardium. In addition, the value of 3-D scintigraphic fusion imaging was assessed in these patients. Results Based on the presence of viable dysfunctional myocardium, 54% of patients with ischemic cardiomyopathy may be considered for coronary revascularization. In 31 of 105 patients, the 3-D fusion imaging was estimated to be helpful in the diagnostic and interpretative process. Conclusion In patients with end-stage coronary artery disease scintigraphic imaging is most important in the decision-making process. Three-dimensional fusion imaging may add important information in approximately 30% of these patients.