Evaluation Of Left Ventricular Remodeling Using Myocardial Nuclear Medicine Imaging

Cardiovascular disease is one of the dieases that may severely harm middle-aged and old people's health and even lead death, It is anextremely common disease in Euramerican countries. In recent years, the incidence of cardiovascular disease exhibits a rapid rising trend in China. Left Ventricular remodeling (LVRM) refers to the changes in size, shape, and function of the heart after acute myocardial infarction (AMI). Ultimately, LVRM, which is closely associated with the poor output of patients, may result in heart failure and increase the incidence of sudden cardiac death. As some researches have shown, patients with serious LVRM may not recover, after successfully coronary artery bypass graft or percutaneous transluminal coronary angioplasty. Therefore, how to judge and quantify the extent of LVR accurately and noninvasively is one of the clinical problems need to be solved.Myocardial metabolic imaging with positron emission tomography (PET) not only provide myocardial perfusion and myocardial viability information but also the function and morphology of the LV. According to the morphology information of LV provided by the myocardial nuclear medicine imaging, this study define some new index to quantify the local extent of LVRM, including DPI (divergent pattern index) of HLA (Horizontal long-axis), short axis HDR (horizontal diameter ratio) and LDR (longitudinal diameter ratio), on the basis of SI (spherical index) representing the overall degree of LVRM.This research mainly based on end-diastolic PET myocardial metabolic imaging of 33 patients (including 21 aneurysm patients and 12 myocardial infraction patients). The correlation coefficients between SI derived by quantitative analysis of end diastolic PET myocardial metabolic imaging and EDV,ESV derived by analysis of MRI images are 0.598 and 0.615, significantly at the 0.01 level (bilateral). The correlation coefficient between SI and EF derived by analysis of MRI images is-0.587, significantly at the 0.01 level (bilateral). The correlation coefficients between DPI of LV anterior,middle HLA faultage, short axis HDR and score for divergent pattern degree of HLA and VLA (Vertical Long-axis) faultage derived by expert expert macroscopic observation are 0.763,0.709,0.722, significantly at the 0.01 level (bilateral). Do further verification on the LV anterior,middle HLA faultage, short axis HDR. We selected 18 patients from 33 patients randomly, then did relevant and regression analysis between DPI of LV anterior,middle HLA faultage, short axis HDR and score for divergent pattern degree of HLA and VLA (Vertical Long-axis) faultage. According to the regression line respectively, we obtained the value of LV anterior,middle HLA faultage DPI and short axis HDR corresponding 2.5 points, which were used to diagnose the remaining 15 patients. When diagnose patient with LV anterior HLA faultage DPI, the false positive rate (FPR) is 0, false negative rate (FNR) was 38%, accuracy was 80%; with LV middle HLA faultage DPI, the FPR was 0, FNR was 29%, accuracy was 87%; with short axis HDR, the FPR is 0, FNR was 42%, accuracy was 80%.At last, we concluded that SI can be used to represent the overall degree of LVRM, DPI of LV anterior, middle HLA and short axis HDR can be used to represent the local degree of LVRM.