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Prevalence and Localization of Hibernating Myocardium Among Patients with Left Ventricular Dysfunction

Emine Acar1, Ayşegül Aksu2, Gökmen Akkaya3

  • 1Department of Nuclear Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey.

Current Medical Imaging Reviews
|February 4, 2020
PubMed

Insights

Myocardial viability studies reveal that perfusion defects in patients with left ventricle dysfunction are equally divided between hibernating and scar tissue. Scar tissue is more prevalent in the left anterior descending artery territory, while hibernation is most common in the right coronary artery territory.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Cardiac Imaging

Background:

  • Left ventricle dysfunction often necessitates revascularization procedures.
  • Assessing myocardial viability is crucial for guiding treatment decisions in such patients.
  • Comorbidities can influence the complexity of managing left ventricle dysfunction.

Purpose of the Study:

  • To quantify hibernating myocardium in patients with left ventricle dysfunction undergoing revascularization.
  • To identify coronary artery territories with higher scar or hibernating tissue burden.
  • To correlate imaging findings with planned surgical or interventional revascularization.

Main Methods:

  • Retrospective analysis of 65 patients (March 2009 - September 2016).
  • Utilized rest technetium-99m sestamibi (Tc-99m MIBI) SPECT and fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT.
  • Defined hibernating myocardium as metabolically active areas with perfusion defects; scar as non-metabolic areas with perfusion defects.

Main Results:

  • Perfusion defects were present in 26% of the myocardium.
  • These defects were composed of approximately 48% hibernating tissue and 52% scar tissue.
  • Defects were most common in the left anterior descending (LAD) artery territory (31%), followed by the right coronary artery (RCA; 23%) and left circumflex artery (LCx; 19%).
  • Hibernation was most prevalent in RCA (64%) and LCx (54%) territories, while scar tissue was more common in the LAD (54%) territory.

Conclusions:

  • Perfusion defects in this cohort represent a near equal mix of hibernating and scar tissue.
  • The LAD territory showed the highest overall perfusion defects, predominantly scar.
  • The RCA territory exhibited the highest proportion of hibernating myocardium.
Abstract

Keywords:
FDGhibernationmyocardiumperfusion defectsscarviability

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