The amount of viable myocardium predicts left ventricular functional improvement and volume reduction in patients with coronary artery disease after coronary artery bypass grafting

This study evaluated the impact of viable myocardium amount before coronary artery bypass grafting (CABG) on left ventricular (LV) functional improvement and LV volume reduction after CABG in patients with coronry artery disease (CAD). Thirty-nine patients underwent gated Tc-99m-MIBI SPECT and F-18-FDG PET before CABG to assess the amount of viable myocardium. Left ventricular ejection fraction (LVEF), LV end-systolic volume (ESV) and LV end-diastolic volume (EDV) were determined before and 3-6 months post-CABG. After CABG, 17 of 39 CAD patients exhibited LVEF improvement (>= 5%) and 26 of 39 CAD patients appeared the reduction in LV end-diastolic volume (EDV) and end-systolic volume (ESV) (>= 10%). Moreover, the amount of viable myocardium before CABG is an independent factor for predicting LVEF improvement (OR = 1.932, P<0.05) and LV volume reduction (OR = 1.623, P<0.05) after CABG by multiple logistic regression analysis. ROC curve analysis showed that the optimal cutoff levels of 4 and 3 viable myocardial segments before CABG can predict LVEF improvement and LV volume reduction after CABG, respectively. The amount of viable myocardium is an independent factor for predicting LVEF improvement and LV volume reduction in CAD patients after CABG. The amount of viable myocardium assessed by combining gated Tc-99m-MIBI SPECT and F-18-FDG PET before CABG can predict LVEF improvement and LV volume reduction after CABG.