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. 2021 Dec;28(6):2812-2822.
doi: 10.1007/s12350-020-02134-z. Epub 2020 May 7.

Preserved myocardial viability in patients with chronic total occlusion of a single coronary artery

Xiao-Xin Sun  1 , Shuheng Li  1   2 , Wei Fang  1 , Yue-Qin Tian  1 , Rui Shen  1 , Hongxing Wei  1 , Zuo-Xiang He  3   4
Affiliations

Preserved myocardial viability in patients with chronic total occlusion of a single coronary artery

Xiao-Xin Sun et al. J Nucl Cardiol. 2021 Dec.

Abstract

Objective: To assess the benefits of coronary collateral circulation on myocardial perfusion, viability and function in patients with total occlusion of a single coronary artery using the 99mTc-sestamibi SPECT and 18F-fluorodeoxyglucose PET.

Methods: 164 Consecutive patients were included who underwent coronary angiography results exhibited total occlusion of a single coronary artery and received 99mTc-MIBI SPECT and 18F-FDG PET within 90 days of angiography. Myocardial perfusion and viability in patients with collateral circulation and those without it were compared. Long-term follow-up was performed through a review of patient clinical records.

Results: Collateral circulation was present in 56 patients (34%) and absent in 108 patients (66%). The total perfusion defect size in patients with collateral circulation decreased when compared to those without (30% ± 13% to 35% ± 14%, P < .05). The myocardial viability was 22% ± 12% in patients with collateral circulation, and 12% ± 9% in those without (P < .001). The left ventricular ejection fraction was higher, and the end-diastolic and end-systolic left ventricular volumes were lower in patients with collateral circulation (39% ± 11%, 138 ± 66, 89 ± 57) compared to patients without collateral circulation (31% ± 9%, 177 ± 55, 125 ± 48, all P < .001, respectively). Multi-factor logistic regression identified that concerning the variables of sex, age, viable myocardium, collateral circulation, treatment type and others, only treatment type was significantly associated with therapeutic effects (OR 3.872, 95% CI 1.915-7.830, P < .001).

Conclusion: Collateral circulation can preserve resting myocardial blood perfusion and myocardial viability, and help maintain the function of the left ventricular myocardium. The appropriate treatment strategy will have a substantial impact on the therapeutic outcome.

Keywords: Coronary collateral circulation; PET; SPECT; myocardial perfusion; myocardial viability; total coronary occlusion.

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References

    1. Piek JJ. Collateral blood flow and myocardial viability. N Engl J Med 1993;328:1570. - PubMed
    1. Kocaman SA, Arslan U, Tavil Y, Okuyan H, Abaci A, Cengel A. Increased circulating monocyte count is related to good collateral development in coronary artery disease. Atherosclerosis 2008;197:753-6. - DOI
    1. He ZX, Mahmarian JJ, Verani MS. Myocardial perfusion in patients with total occlusion of a single coronary artery with and without collateral circulation. J Nucl Cardiol 2001;8:452-7. - DOI
    1. Aboul-Enein F, Kar S, Hayes SW, Sciammarella M, Abidov A, Makkar R, et al. Influence of angiographic collateral circulation on myocardial perfusion in patients with chronic total occlusion of a single coronary artery and no prior myocardial infarction. J Nucl Med 2004;45:950-5. - PubMed
    1. Ling LF, Marwick TH, Flores DR, Jaber WA, Brunken RC, Cerqueira MD, et al. Identification of therapeutic benefit from revascularization in patients with left ventricular systolic dysfunction: Inducible ischemia versus hibernating myocardium. Circ Cardiovasc Imaging 2013;6:363-72. - DOI

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