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Relationship between collateral circulation and myocardial viability of 18F-FDG PET/CT subtended by chronic total occluded coronary arteries

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Abstract

Objective

To analyze the relationship between the collateral flow of coronary chronic total occlusion (CTO) and myocardial viability detected by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging.

Methods

A prospective analysis of 104 patients diagnosed by coronary angiography. All patients underwent resting myocardial perfusion imaging and PET/CT within 1 week. The collateral circulation was graded with Rentrop classification as no or poor collateral circulation in 16 CTO vessels, moderate collateral circulation in 34 CTO vessels, and good collateral circulation in 69 CTO vessels. Myocardial viability was determined with myocardial perfusion imaging and PET. The patterns were interpreted as mismatch, match and normal perfusion and 18F-FDG uptake.

Results

There was no significant correlation between the severity and extent of perfusion defect, myocardial viability and collateral circulation grade. The myocardial viability was normal in mild and moderate hypokinetic regions and decreased in severe hypokinetic and akinesis–dyskinesis regions. The presence of collateral circulation was a sensitive (89%) but not a specific (31%) sign of myocardial viability.

Conclusions

In patients with CTO, collateral circulation does not seem to be an effective way for predicting myocardial viability. Further analysis of PET patterns of viable myocardium is needed to guide further revascularization and predict functional improvement and survival benefit.

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Acknowledgements

We are grateful to Feng Wang for their excellent technical support. The work described here has not been submitted anywhere else for potential publication.

Funding

Capital Clinical Characteristics Application Study (Z161100000516139). Beijing LiSheng Cardiovascular Health Foundation Pilot Fund Project (LHJJ20158521).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen road, Chaoyang District, Beijing, 100029, China

    Wei Dong, Hongzhi Mi, Jian Jiao & Quan Li

  2. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen road, Chaoyang District, Beijing, 100029, China

    Jianan Li & Xiantao Song

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  1. Wei Dong
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  2. Jianan Li
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  3. Hongzhi Mi
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Correspondence to Hongzhi Mi or Xiantao Song.

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Dong, W., Li, J., Mi, H. et al. Relationship between collateral circulation and myocardial viability of 18F-FDG PET/CT subtended by chronic total occluded coronary arteries. Ann Nucl Med 32, 197–205 (2018). https://doi.org/10.1007/s12149-018-1234-3

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  • DOI: https://doi.org/10.1007/s12149-018-1234-3

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