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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2002 October;43(5):603-7
Prediction of improvement in regional left ventricular function after coronary artery bypass grafting: quantitative stress-redistribution 201Tl imaging in detection of myocardial viability
Imamaki M., Maeda T., Tanaka S., Sugawara Y., Shimakura T.
Department of Cardiovascular Surgery Fukuyama Cardiovascular Hospital, Fukuyama, Japan
Background. This study investigated the usefulness of quantitative assessment of Thallium-201 stress redistribution myocardial scintigraphy combined with quantitative assessment of regional left ventricular function using the centerline method for predicting of recovery regional left ventricular function following myocardial revascularization.
Methods. Twenty patients with chronic total obstruction of the proximal portion of left anterior descending artery and/or right coronary artery were studied. Percent Tl-uptake method was used to evaluate myocardial viability before CABG. Regional LV function was evaluated before and after CABG with the centerline method. The territory of LAD was defined by chords 10 to 58 and that of RCA was defined by chords 59 to 80 in the centerline method. The parameter of regional left ventricular function was the mean (SF-Av.)/SD of each LAD and RCA territory.
Results. In cases showing a % uptake value under 50%, the preoperative value of (SF-Av.)/SD was -3.18±0.74 and postoperative value was -2.63±0.8 1. The difference between these values was not significant. When the %uptake value over 50%, the preoperative value of (SF-Av.)/SD was -2.80±0.49 and the postoperative value was -2.27±0.28. The postoperative value was significantly higher than the preoperative value(p=0.007).
Conclusions. Even in cases of severe left ventricular dysfunction, regional left ventricular function improved if the value of % uptake in the redistribution Thallium imaging was 50% or over. Quantitative analysis of myocardial scintigraphy combined with quantitative analysis of left ventriculography is a useful method for predicting recovery of regional left ventricular function following myocardial revascularization.