Objective To analyze the relationship between the collateral flow of coronary chronic total occlusion (CTO) and myocardial viability detected by F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging. Methods A prospective analysis of 104 patients diagnosed by coronary angiography. All patients underwent resting myo- cardial perfusion imaging and PET/CT within 1 week. The collateral circulation was graded with Rentrop classification as no or poor collateral circulation in 16 CTO vessels, moderate collateral circulation in 34 CTO vessels, and good collateral circulation in 69 CTO vessels. Myocardial viability was determined with myocardial perfusion imaging and PET. The pat- terns were interpreted as mismatch, match and normal perfusion and F-FDG uptake. Results There was no significant correlation between the severity and extent of perfusion defect, myocardial viability and collateral circulation grade. The myocardial viability was normal in mild and moderate hypokinetic regions and decreased in severe hypokinetic and akinesis–dyskinesis regions. The presence of collateral circulation was a sensitive (89%) but not a specific (31%) sign of myocardial viability. Conclusions In patients with CTO, collateral circulation does not seem to be an effective way for predicting myocardial viability. Further analysis of PET patterns of viable myocardium is needed to guide further revascularization
Annals of Nuclear Medicine – Springer Journals
Published: Jan 29, 2018
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