PMID- 29516366 OWN - NLM STAT- MEDLINE DCOM- 20201014 LR - 20240130 IS - 1532-6551 (Electronic) IS - 1071-3581 (Linking) VI - 26 IP - 5 DP - 2019 Oct TI - Relationship of myocardial hibernation, scar, and angiographic collateral flow in ischemic cardiomyopathy with coronary chronic total occlusion. PG - 1720-1730 LID - 10.1007/s12350-018-1241-8 [doi] AB - BACKGROUND: The relationship between myocardial viability and angiographic collateral flow is not fully elucidated in ischemic cardiomyopathy (ICM) with coronary artery chronic total occlusion (CTO). We aimed to clarify the relationship between myocardial hibernation, myocardial scar, and angiographic collateral flow in these patients. METHODS AND RESULTS: Seventy-one consecutive ICM patients with 122 CTOs and 652 dysfunctional segments within CTO territories were retrospectively analyzed. Myocardial hibernation (perfusion-metabolism mismatch) and the extent of (18)F-fluorodeoxyglucose (FDG) abnormalities were assessed using (99m)Tc-sestamibi and (18)F-FDG imaging. Myocardial scar was evaluated by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging. Collateral flow observed on coronary angiography was assessed using Rentrop classification. In these patients, neither the extent nor frequency of myocardial hibernation or scar was related to the status of collateral flow. Moreover, the matching rate in determining myocardial viability was poor between any 2 imaging indices. The extent of (18)F-FDG abnormalities was linearly related to the extent of LGE rather than myocardial hibernation. Of note, nearly one-third (30.4%) of segments with transmural scar still had hibernating tissue. Hibernation and non-transmural scar had higher sensitivity (63.0% and 66.7%) than collateral flow (37.0%) in predicting global functional improvement. CONCLUSIONS: Angiographic collateral cannot accurately predict myocardial viability, and has lower sensitivity in prediction of functional improvement in CTO territories in ICM patients. Hence, assessment of myocardial viability with non-invasive imaging modalities is of importance. Moreover, due to the lack of correlation between myocardial hibernation and scar, these two indices are complementary but not interchangeable. FAU - Wang, Li AU - Wang L AD - Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Lu, Min-Jie AU - Lu MJ AD - Department of Radiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, A 167, Beilishi Road, Xicheng District, Beijing, 100037, China. FAU - Feng, Lei AU - Feng L AD - State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, A 167, Beilishi Road, Xicheng District, Beijing, 100037, China. FAU - Wang, Juan AU - Wang J AD - Emergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Fang, Wei AU - Fang W AD - Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - He, Zuo-Xiang AU - He ZX AD - Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Dou, Ke-Fei AU - Dou KF AD - State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, A 167, Beilishi Road, Xicheng District, Beijing, 100037, China. drdoukefei@126.com. FAU - Zhao, Shi-Hua AU - Zhao SH AD - Department of Radiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, A 167, Beilishi Road, Xicheng District, Beijing, 100037, China. cjr.zhaoshihua@vip.163.com. FAU - Yang, Min-Fu AU - Yang MF AD - Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Chaoyang District, Beijing, 100020, China. minfuyang@126.com. LA - eng PT - Journal Article DEP - 20180307 PL - United States TA - J Nucl Cardiol JT - Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology JID - 9423534 RN - 0 (Contrast Media) RN - 0Z5B2CJX4D (Fluorodeoxyglucose F18) RN - 971Z4W1S09 (Technetium Tc 99m Sestamibi) RN - AU0V1LM3JT (Gadolinium) SB - IM CIN - J Nucl Cardiol. 2019 Oct;26(5):1731-1733. PMID: 29651738 MH - Aged MH - Cardiomyopathies/*diagnostic imaging MH - Contrast Media MH - *Coronary Angiography MH - Coronary Occlusion/*diagnostic imaging MH - Female MH - Fluorodeoxyglucose F18 MH - Gadolinium MH - Heart/*diagnostic imaging MH - Heart Failure/diagnostic imaging MH - Humans MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Myocardial Ischemia/*pathology MH - Myocardial Perfusion Imaging MH - Myocardium/*pathology MH - Positron Emission Tomography Computed Tomography MH - Retrospective Studies MH - Sensitivity and Specificity MH - Technetium Tc 99m Sestamibi MH - Tomography, Emission-Computed, Single-Photon OTO - NOTNLM OT - Ischemic cardiomyopathy OT - chronic total occlusion OT - collateral OT - myocardial viability EDAT- 2018/03/09 06:00 MHDA- 2020/10/21 06:00 CRDT- 2018/03/09 06:00 PHST- 2017/08/08 00:00 [received] PHST- 2018/02/13 00:00 [accepted] PHST- 2018/03/09 06:00 [pubmed] PHST- 2020/10/21 06:00 [medline] PHST- 2018/03/09 06:00 [entrez] AID - S1071-3581(23)06313-4 [pii] AID - 10.1007/s12350-018-1241-8 [doi] PST - ppublish SO - J Nucl Cardiol. 2019 Oct;26(5):1720-1730. doi: 10.1007/s12350-018-1241-8. Epub 2018 Mar 7.