TY - JOUR
T1 - Myocardial viability in chronic ischemic heart disease
T2 - Comparison of contrast-enhanced magnetic resonance imaging with 18F-fluorodeoxyglucose positron emission tomography
AU - Kühl, Harald P.
AU - Beek, Aernout M.
AU - Van Der Weerdt, Arno P.
AU - Hofman, Mark B.M.
AU - Visser, Cees A.
AU - Lammertsma, Adriaan A.
AU - Heussen, Nicole
AU - Visser, Frans C.
AU - Van Rossum, Albert C.
PY - 2003/1/1
Y1 - 2003/1/1
N2 - OBJECTIVES: We sought to compare contrast-enhanced magnetic resonance imaging (ceMRI) with nuclear metabolic imaging for the assessment of myocardial viability in patients with chronic ischemic heart disease and left ventricular (LV) dysfunction. BACKGROUND: Contrast-enhanced MRI has been shown to identify scar tissue in ischemically damaged myocardium. METHODS: Twenty-six patients with chronic coronary artery disease and LV dysfunction (mean ejection fraction 31 ± 11%) underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), technetium-99m tetrofosmin single-photon emission computed tomography (SPECT), and ceMRI. In a 17-segment model, the segmental extent of hyperenhancement (SEH) by ceMRI, defined as the relative amount of contrast-enhanced tissue per myocardial segment, was compared with segmental FDG and tetrofosmin uptake by PET and SPECT. RESULTS: In severely dysfunctional segments (n = 165), SEH was 9 ± 14%, 33 ± 25% (p < 0.05), and 80 ± 23% (p < 0.05) in segments with normal metabolism/perfusion, metabolism/perfusion mismatch, and matched defects, respectively. Segmental glucose uptake by PET was inversely correlated to SEH (r = -0.86, p < 0.001). By receiver operator characteristic curve analysis, the area under the curve was 0.95 for the differentiation between viable and non-viable segments. At a cutoff value of 37%, SEH optimally differentiated viable from non-viable segments defined by PET. Using this threshold, the sensitivity and specificity of ceMRI to detect non-viable myocardium as defined by PET were 96% and 84%, respectively. CONCLUSIONS: Contrast-enhanced MRI allows assessment of myocardial viability with a high accuracy, compared with FDG-PET, in patients with chronic ischemic heart disease and LV dysfunction.
AB - OBJECTIVES: We sought to compare contrast-enhanced magnetic resonance imaging (ceMRI) with nuclear metabolic imaging for the assessment of myocardial viability in patients with chronic ischemic heart disease and left ventricular (LV) dysfunction. BACKGROUND: Contrast-enhanced MRI has been shown to identify scar tissue in ischemically damaged myocardium. METHODS: Twenty-six patients with chronic coronary artery disease and LV dysfunction (mean ejection fraction 31 ± 11%) underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), technetium-99m tetrofosmin single-photon emission computed tomography (SPECT), and ceMRI. In a 17-segment model, the segmental extent of hyperenhancement (SEH) by ceMRI, defined as the relative amount of contrast-enhanced tissue per myocardial segment, was compared with segmental FDG and tetrofosmin uptake by PET and SPECT. RESULTS: In severely dysfunctional segments (n = 165), SEH was 9 ± 14%, 33 ± 25% (p < 0.05), and 80 ± 23% (p < 0.05) in segments with normal metabolism/perfusion, metabolism/perfusion mismatch, and matched defects, respectively. Segmental glucose uptake by PET was inversely correlated to SEH (r = -0.86, p < 0.001). By receiver operator characteristic curve analysis, the area under the curve was 0.95 for the differentiation between viable and non-viable segments. At a cutoff value of 37%, SEH optimally differentiated viable from non-viable segments defined by PET. Using this threshold, the sensitivity and specificity of ceMRI to detect non-viable myocardium as defined by PET were 96% and 84%, respectively. CONCLUSIONS: Contrast-enhanced MRI allows assessment of myocardial viability with a high accuracy, compared with FDG-PET, in patients with chronic ischemic heart disease and LV dysfunction.
UR - http://www.scopus.com/inward/record.url?scp=0345382520&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/S0735-1097(03)00158-X
DO - https://doi.org/10.1016/S0735-1097(03)00158-X
M3 - Article
C2 - 12706930
SN - 0735-1097
VL - 41
SP - 1341
EP - 1348
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 8
ER -