Is There an Association Between Hibernating Myocardium and Left Ventricular Mechanical Dyssynchrony in Patients With Myocardial Infarction?

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Objective: Left Ventricular Mechanical Dyssynchrony (LVMD) in an important factor in the prognosis of patients with myocardial infarction (MI). The aim of this study was to identify the correlation between LVMD and hibernating myocardium in MI patients by radionuclide myocardial imaging. Subjects and Methods: This study consisted of 91 patients who had a history of definite prior MI and underwent both technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) gated single photon emission tomography (SPET) myocardial perfusion imaging (MPI) and fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) myocardial metabolic imaging. Left ventricular (LV) functional and LVMD parameters were measures from gated SPET MPI, while myocardial visibility was assessed by the integral quantitative analysis of SPET MPI and 18F-FDG PET. Left ventricular MD was defined as >mean+2SD of phase bandwidth (PBW) in the control group. Results: Left ventricular MD was present in 37/91 (40.7%) MI patients. The extent of hibernating myocardium (SPET/PET mismatch) and scar (SPET/PET match) in patients with LVMD was significantly higher than in patients without LVMD (15.24±11.26% vs 4.89±5.41%, P6.5%, hibernating myocardium as a threshold can be used to predict LVMD. In addition, the improvement of PBW (ΔPBW) after coronary artery bypass graft (CABG) at a median follow-up time of 6 months was related with the amount of hibernating myocardium. Conclusion: Myocardial infarction patients with left ventricular mechanical dyssynchrony showed significantly more segments of hibernating myocardium and scars as compared to those without LVMD. Hibernating myocardium is independently associated with LVMD in MI patients.

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Hellenic Journal of Nuclear Medicine





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