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Updated: Jul 11, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Outcomes of coronary artery bypass grafting based on myocardial perfusion imaging
Vishesh Sharma1, Anil Jain1, Vishal Patel2
1Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center, (Affiliated to B.J. Medical College), Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.
Insights
Myocardial perfusion imaging (MPI) accurately assesses myocardial viability and functional improvement after coronary artery bypass grafting, aiding surgical decisions for complex coronary artery disease (CAD) patients.
Area of Science:
- Cardiology and Nuclear Medicine
Background:
- Coronary artery disease (CAD) is a leading global cause of mortality and disability.
- Revascularization strategies aim to improve cardiac function in patients with viable myocardium.
Purpose of the Study:
- To evaluate the utility of myocardial perfusion imaging (MPI) in identifying viable myocardium.
- To assess functional improvement post-revascularization using MPI.
Main Methods:
- Prospective observational study in CAD patients undergoing coronary artery bypass grafting.
- Preoperative and 1-year postoperative evaluation using 2D echocardiography and MPI.
Main Results:
- MPI demonstrated significant improvement in ejection fraction (35.98% to 45.51%, p ≤ 0.0001).
- Reduced summed rest score (24.28 to 18.02, p ≤ 0.0001) and total perfusion deficit (32.44% to 25.61%, p ≤ 0.0001) were observed.
- MPI findings correlated with 2D echocardiography and patient well-being.
Conclusions:
- MPI accurately assesses myocardial functional improvement after revascularization.
- MPI is a valuable non-invasive tool for evaluating patients with diffuse CAD and low ejection fractions, including those considered inoperable.
Introduction:
Coronary artery disease (CAD) is the foremost single cause of mortality and loss of disability-adjusted life years globally and a large percentage of this burden is found in low and middle income countries, with the treatment strategies based on revascularisation, based on studies that have shown that on revascularisation of viable myocardium there is an improvement of function over a period of time.
Aim:
To evaluate the utilization of myocardial perfusion imaging (MPI) for identifying viable myocardium and assessing the improvement.
Material And Methods:
This prospective observational study was conducted in patients having CAD planned for coronary artery bypass grafting. The patients were evaluated using 2D ECHO and MPI preoperatively and postoperatively after 1 year.
Results:
Mean ejection fraction preoperatively was 40.6 ±9.72% and postoperatively it improved to 41.32 ±10.64% and ejection fraction was calculated using MPI and an average improvement from 35.98 ±12.72% to 45.51 ±12.61% (p ≤ 0.0001). Summed rest score was calculated and an improvement was noted from 24.28 ±8.47 to 18.02 ±8.75 (p ≤ 0.0001). Total perfusion deficit was calculated and was found to have reduced from 32.44 ±11.98 to 25.61 ±12.23 (p ≤ 0.0001).
Conclusions:
MPI was able to accurately assess the improvement, which correlated not only with the 2D echocardiography data but also with the clinical wellbeing of the patients. Being a non-invasive, quick procedure, it should be added to the arsenal of the cardiac surgeon for evaluation of patients with diffuse diseases, low ejection fractions, patients who might generally be considered inoperable.
