Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Sign In to gain access to subscriptions and/or personal tools.
The British Journal of Diabetes & Vascular Disease
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Hegazy, H.
Right arrow Articles by Al-Halees, Z.
Right arrow Search for Related Content
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PET scan before CABG in diabetes

Hesham Hegazy

Section of Adult Cardiology; Riyadh and Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia, leiterl{at}smh.toronto.on.ca

Ayman Refaei

Nuclear Medicine; Riyadh and Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia

Azza Assedique

Nuclear Medicine; Riyadh and Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia

Shukri Alsaif

Section of Adult Cardiology; Riyadh and Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia

Mayada Taha

Internal Medicine; Riyadh and Saud Al-Babtain Cardiac Center, Dammam. Saudi Arabia

Mostafa Refaei

Section of Adult Cardiology; Riyadh and Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia

Nasser Elkum

Biomedical Statistics; Riyadh and Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia

Hamed Alomran

Cardiovascular anesthesia; Riyadh and Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia

Zohair Al-Halees

Cardiac Surgery King Faisal Specialist Hospital and Research Center, Riyadh and Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia

Background and objectives

Since the role of positron emission tomography (PET) scanning in diabetes is not clear, this study sought to assess the usefulness of PET scanning for viability in this patient group.

Methods

Forty-four per cent insulin-treated, and 56% non-insulin-treated diabetic patients with severely impaired left ventricular function (LVEF 29± 9%) underwent first coronary artery bypass grafting (CABG). Pre-operative viability was assessed by PET scan.

Results

Eighty-two per cent of patients received ≥3 grafts. Twenty-seven patients were discharged home and followed for a mean 3.5±1.6 years. Postoperative LVEF improved to 40±9 (p<0.0001). Multiple regression analysis indicated that the only variable that predicted improvement in global LV function was presence of hibernating segments at PET scan. The single variable that predicted deterioration of LVEF was the number of segments with reduced perfusion and metabolism at PET scan.

Conclusion

PET scan is an accurate tool for prediction of global left ventricular function recovery following CABG in people with diabetes.

Key Words: coronary artery disease • diabetes,impaired left ventricular function • hibernating myocardium • bypass surgery.

References

  • Remme WJ, Swedberg K. Task force for the diagnosis and treatment of chronic heart disease, European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J 2001;22: 1527-60.[Free Full Text]
  • Cohn JN, Johnson GR, Shabeti R. et al. Ejection fraction, peak exercise oxygen consumption cardiothoracic ratio as determinants of prognosis in heart failure. Circ 1993;87:v1-6-v1-16.
  • Trachiotis GD, Weintraub WS, Johnston TS et al. Coronary artery by pass grafting in patients with left ventricular dysfunction. Ann Thoracic Surg 1998;66:1632-9.[Abstract/Free Full Text]
  • Nemec P., Bedanova H., Necolas J. et al. Coronary artery bypass grafting in patients with left ventricular ejection fraction of 30% or less. Brastil Lek Listy 2001;102(1):15-21.
  • Luciani GB, Montalbano G., Casali G. et al. Predicting long term functional results after myocardial revascularization in ischemic cardiomyopathy. J Thoracic Cardiovasc Surg 2000;120:478-89.[Abstract/Free Full Text]
  • Topkara VK, Cheema FH, Kesavaramanujam S. et al. Coronary artery bypass grafting in patients with low EF. Circ 2002;112(suppl 9):1344-50.
  • Alexanderson E. Usefullness of nuclear technique in the study of myocardial viability. Arch Cardiol Mex 2004;74(suppl 1):S8-S12.[Medline] [Order article via Infotrieve]
  • Rahimtoola S. The hibernating myocardium. Am Heart J 1989;117:211-21.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Clenland JG, Pennel DJ, Ray SG et al. Myocardial viability as a determinant of the ejection fraction response to carvedilol in patients with heart failure. Lancet 2002;362:14-21.[Web of Science]
  • Pezard P., Jallet P. Myocardial viability: study of viability by myocardial scintigraphy. Press Med 1998;27:1043-9.
  • Ghesani M., Depuey FG, R Zanski A. Role of F-18 FDG positron emission tomography in the assessment of myocardial viability. Echocardiogr 2005;22:165-77.[CrossRef]
  • Koszegi Z., Galuskal L., Szakal S. Jr et al. The role of PET scan among cardiologic imaging methods. Orv Hetol 2002;143(suppl 3):1314-16.
  • Giorgetti A., Marzullo P., Sambuceti G. et al. Baseline / post nitrate Tc-99m tetrofosmine mismatch for the assessment of myocardial viability in patients with severe left ventricular dysfunction: comparison with baseline Tc-99m tetrofosmine scintigraphy / FDG PET imaging. J Nucl Cardiol 2004;11:142-51.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Maddahi J., Schelbert H., Brunken R. et al. Role of Tl-201 and PET imaging in evaluation of myocardial viability and management of patients with coronary artery disease and left ventricular dysfunction. J Nucl Med 1994;3S:707-15.
  • Schelbet H. Metabolic imaging to assess myocardial viability. J Nucl Med 1994;35(suppl):5S-14S.
  • Thourani VH, Weintraub WS, Stien B. et al. Influence of DM on early and late outcome after coronary artery bypass grafting. Ann Thoracic Surg 1999;67:1045-52.[Abstract/Free Full Text]
  • Bax JJ, Veening MA, Visserf C. et al. Optimal metabolic conditions during FDG imaging: A comparative study between different protocols. Eur J Nucl Med 1997;24:35[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • 18. Von Dahi J., Herman WH, Hicks RJ et al. Myocardial glucose uptake in patients with insulin dependent diabetes mellitus assessed quantitatively by dynamic positrone emission tomography. Circ 1997;88:395-404.
  • Bax JJ, Visser FC, Poldman D. et al. Feasibility, safety and image quality of cardiac PET imaging study during hyperinsulinemic-euglycemic clamping. Eur J Nucl Med Mol Imaging 2002;29:452-7.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Schinkel Af, Bax JJ, Valkema R. et al. Effect of DM on myocardial 18-F-FDG SPECT using Acipimox for assessment of myocardial viability. J Nucl Med 2003;44:877-83.[Abstract/Free Full Text]
  • Bacharach SL, Bax JJ, Case J. et al. PET myocardial glucose metabolism and perfusion imaging. Part 1: Guidelines for patient preparation and data acquisition. J Nucl Card 2003;10:543-54.[CrossRef]
  • Schiller NB, Shah PM, Crawford M. et al. Recommendations for quantitation of the left ventricle function by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 1989;2:358-67.[Medline] [Order article via Infotrieve]
  • Lucignani G., Andoni C., Paolini G. et al. PET for assessment of myocardial viability: a synopsis of methods and indications. Rays 1999;24(1):81-95.[Medline] [Order article via Infotrieve]
  • Bouchart F., Tabley A., Litzer P.y et al. Myocardial revascularization in patients with severe ischemic left ventricular dysfunction: Long term follow up in 141 patients. Eur J Cardiothoracic Surg 2001;20:1157-62.[Abstract/Free Full Text]
  • Flaming WJ, Shivalkar B., Spiessens B. et al. PET scan predicts recovery of the left ventricular function after coronary artery bypass. Ann Thorac Surg 1997;64:1695-701.

The British Journal of Diabetes & Vascular Disease, Vol. 7, No. 1, 32-37 (2007)
DOI: 10.1177/14746514070070010601


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?



This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Hegazy, H.
Right arrow Articles by Al-Halees, Z.
Right arrow Search for Related Content
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?