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Myocardial perfusion reserve in spared myocardium: correlation with infarct size and left ventricular ejection fraction

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Left ventricular ejection fraction (LVEF) after myocardial infarction is considered to be determined by the size of the infarction and residual function of the spared myocardium. Myocardial perfusion reserve (MPR) has been shown to be a strong prognostic factor in patients with ischaemic heart failure, even stronger than LVEF. In the present study, the interrelationship between MPR, LVEF and infarct size was investigated.

Methods

In total, 102 patients with a prior history of myocardial infarction were included. All underwent rest and stress 13N-ammonia and gated 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) for evaluation of myocardial ischaemia and viability. FDG polar maps were used to determine the size of the infarction. The LVEF was obtained by gated 18F-FDG PET or another available method within 3 months of the PET scan. MPR was obtained per segment in the spared myocardium.

Results

The mean age of the subjects was 68 ± 12 years. Global MPR was 1.63 ± 0.51. The mean LVEF was 36 ± 10 % and mean infarct size 23.72 ± 14.8 %. A linear regression model was applied for the analysis considering the LVEF as a dependent variable. All risk factors, mean stress flow, infarct size and MPR were entered as variables. The infarct size (p < 0.001) and MPR (p = 0.04) reached statistical significance. In a multivariate model MPR had a stronger correlation with LVEF than infarct size.

Conclusion

In patients with a prior history of myocardial infarction, LVEF is not just related to infarct size but also to MPR in the spared myocardium.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands

    Luis Eduardo Juárez-Orozco, Julius Glauche, Hendrikus H. Boersma, Andor W. J. M. Glaudemans, Rudi A. Dierckx & Riemer H. J. A. Slart

  2. Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico

    Luis Eduardo Juárez-Orozco & Erick Alexanderson

  3. Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Clark J. Zeebregts

  4. Department of Clinical and Hospital Pharmacy, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Hendrikus H. Boersma

  5. Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Dirk J. van Veldhuisen & René A. Tio

  6. Department of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium

    Rudi A. Dierckx

  7. Cardiovascular Imaging and Nuclear Medicine Department, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico

    Erick Alexanderson

Authors
  1. Luis Eduardo Juárez-Orozco
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  2. Julius Glauche
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  3. Erick Alexanderson
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  4. Clark J. Zeebregts
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  5. Hendrikus H. Boersma
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  6. Andor W. J. M. Glaudemans
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  7. Rudi A. Dierckx
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  8. Dirk J. van Veldhuisen
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  9. René A. Tio
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  10. Riemer H. J. A. Slart
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Corresponding author

Correspondence to Riemer H. J. A. Slart.

Additional information

René A. Tio and Riemer H. J. A. Slart contributed equally to this work.

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Juárez-Orozco, L.E., Glauche, J., Alexanderson, E. et al. Myocardial perfusion reserve in spared myocardium: correlation with infarct size and left ventricular ejection fraction. Eur J Nucl Med Mol Imaging 40, 1148–1154 (2013). https://doi.org/10.1007/s00259-013-2394-y

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  • DOI: https://doi.org/10.1007/s00259-013-2394-y

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