Prediction of Changes in Left Ventricular Ejection Fraction after Off-Pump Coronary Artery Bypass Grafting Surgery by Myocardial Perfusion Single-Photon Emission Computed Tomography

  • سال انتشار: 1394
  • محل انتشار: مجله پزشکی قلب و قفسه سینه، دوره: 3، شماره: 3
  • کد COI اختصاصی: JR_JCTM-3-3_006
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 435
دانلود فایل این مقاله

نویسندگان

Maryam Mirzaie

Resident of Community Medicine, Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Asadollah Mirzaie

Cardiac Surgeon, Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, Iran

Majid Assadi

Nuclear Physician, The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran

Rasoul Zakavi

Nuclear Physician, Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

چکیده

Introduction: Left ventricular ejection fraction (LVEF) is considered to be the single most important prognostic factor in patients with previous myocardial infarction. LVEF is not improved in all patients after coronary artery bypass grafting (CABG). This study aimed to assess the possibility of prediction of LVEF changes after CABG using myocardial perfusion gated signle photon emission computed tomography (GSPECT). Materials and Methods: Overall, 48 patients with mean LVEF of 30.2% (±4.7) underwent Echocardiography and GSPECT after injection of Tc-99m-MIBI at rest. Myocardial uptake was evaluated in 17 myocardial segments and was compared with age and gender matched normal data pool. The risks and benefits of CABG were explained to the patients and 16 cases (15 male and 1 female) with the mean age of 61.1 years (±10.8) accepted to undergo off-pump CABG. All the patients were followed-up for at least six months and echocardiography and GSPECT were repeated at the end of follow up. Results: The mean LVEF was increased from of 31.1% (±3.5) to 34.5% (±3.6) after surgery (P< 0.001). Delta LVEF was defined as ΔLVEF=LVEF (before CABG) - LVEF (after CABG). ΔLVEF was within the range of 0-8% with the mean of 3.4% (±2.5). The number of non-viable myocardial segments was not significantly different between patients with ΔLVEF ≥ 5% and those with smaller changes. Myocardial perfusion was estimated for all segments, and the mean global uptake was defined by adding the mean uptake in all segments, divided by 17. The mean global uptake was 53.1% in our patients. Regression analysis revealed that ΔLVEF after CABG can be predicted reliably using the following formula: ΔLVEF= -33.8 + (0.77 × mean global uptake) (P< 0.01). Conclusion: Our study showed that change of LVEF after CABG can be predicted reliably using mean global uptake in preoperative myocardial perfusion SPECT at rest.

کلیدواژه ها

Coronary artery bypass grafting, Left Ventricular Function, myocardial perfusion imaging

اطلاعات بیشتر در مورد COI

COI مخفف عبارت CIVILICA Object Identifier به معنی شناسه سیویلیکا برای اسناد است. COI کدی است که مطابق محل انتشار، به مقالات کنفرانسها و ژورنالهای داخل کشور به هنگام نمایه سازی بر روی پایگاه استنادی سیویلیکا اختصاص می یابد.

کد COI به مفهوم کد ملی اسناد نمایه شده در سیویلیکا است و کدی یکتا و ثابت است و به همین دلیل همواره قابلیت استناد و پیگیری دارد.