| Objective:To study the correlation between myocardial viability and coronary artery stenosis in Ischemic cardiomyophathy by Positron emission tomography/computedtomography.Methods:A data of 44 patients were diagnosed as ICM patients who underwent both PET/CT 13N-NH3 myocardial perfusion and FDG myocardial metabolism imaging.The 17 segments of left ventricle were divided into the Apex Anterior Anteroseptal Anterolateral Inferolateral Inferior Inferoseptal.Respectively corresponding to the blood supply area of left anterior descending branch(LAD),Left circumflex branch(LCX)and Right coronary artery(RCA).The 5 points method was used to make a semi quantitative comparison of the radiological distribution in each segment:normal =0,mild defect =1,moderate defect =2,severe defect =3,and complete defect =4.There were 4 types of myocardial activity:normal myocardium was perfused and metabolic normal(0/0 point);complete viable myocardium was myocardial perfusion and metabolic mismatch(1～4/0 point);partial survival myocardium was perfusion metabolic partial mismatch(1～4/1～3 point);Inactive myocardium was perfusion metabolic match(4/4 point).All patients were examined by coronary angiography(CAG).Results:(1)There was a significant difference in the distribution of myocardial activity between three coronary arteries(p<0.05),and the survival rate of each coronary artery was LCX>RCA>LAD.(2)The myocardial activity of different coronary artery stenosis groups in LAD was significantly different(P<0.05).The results showed that the survival myocardium was 85(67.5%),118(93.7%),41(97.6%),14(100%)respectively when LAD stenosis was 100%,70%-99%,50%-69%and 50%.Degree of LAD stenosis and apex,anterior,anteroseptal myocardial activity showed a significant negative correlation(p<0.05).There was no significant difference in myocardial activity in LCX group with different degree of coronary stenosis(p>0.05).When LCX stenosis was 100%,70%-99%,50%-69%,and<50%,the survival myocardium was 15(100%),97(97%),35(100%),64(91.4%),respectively.There was no correlation between the degree of LCX stenosis and the activity of the anterior wall and inferior wall myocardium(p>0.05).There was a significant negative correlation between the degree of RCA stenosis and the activity of inferior wall myocardium(p<0.05),and no correlation between the stenosis degree of RCA and the activity of inferior wall myocardium(p>0.05).The degree of stenosis of three coronary arteries is mainly composed of viable myocardium.Conclusion:(1)The myocardial survival rate of three coronary artery supply areas of ICM patients is different,of which the myocardial activity in the LAD blood supply area is the most serious,and the survival rate of myocardium is LAD<RCA<LCX.(2)The degree of different coronary artery stenosis in ICM patients is mainly composed of viable myocardium.When coronary artery occlusion is complete,the myocardial viability is still high,which has the significance of revascularization. |
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