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Updated: Jun 22, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Effect of patent complete revascularization on myocardium with persistent perfusion defects in preoperative
Min-Seok Kim1,2, Joon Yeun Park3, Seong Wook Hwang1
1Cardiovascular Center, Myongji Hospital, Gyeonggi-do, Republic of Korea.
Insights
Coronary artery bypass grafting (CABG) improves myocardial perfusion. Even with patent grafts, persistent perfusion defects indicate areas that benefit from complete revascularization.
Area of Science:
- Cardiology
- Nuclear Medicine
- Cardiovascular Surgery
Background:
- Coronary artery bypass grafting (CABG) is a common treatment for coronary artery disease.
- Assessing myocardial perfusion post-CABG is crucial for evaluating treatment success.
- Persistent perfusion defects may indicate suboptimal revascularization despite patent grafts.
Purpose of the Study:
- To evaluate changes in myocardial perfusion after CABG using single-photon emission computed tomography (SPECT).
- To examine myocardial segments with persistent preoperative perfusion defects in patients with all patent grafts one year post-CABG.
Main Methods:
- Included patients with complete revascularization and patent grafts one year post-CABG.
- Utilized preoperative and 3, 12-month postoperative SPECT (stress/rest) with a 17-segment model.
- Calculated difference scores (DSs) for segments with impaired stress perfusion, categorizing them into Group P (DS ≤1) and Group R (DS ≥2).
Main Results:
- Analyzed 761 segments with impaired stress perfusion from 120 patients.
- Observed decreased stress scores in both groups post-CABG, with more significant changes in Group R.
- Noted a trend of decreasing rest scores in Group R compared to Group P during the first postoperative year.
Conclusions:
- Complete revascularization, even in areas with persistent perfusion defects, should be considered during CABG.
- This approach may optimize myocardial recovery and long-term outcomes.
Objectives:
This study aimed to evaluate the changes in perfusion assessed by myocardial single-photon emission computed tomography after coronary artery bypass grafting (CABG) and to examine the myocardial segments with persistent perfusion defect preoperatively in patients who underwent CABG and who had all patent grafts 1 year postoperatively.
Methods:
Patients who underwent complete revascularization, who were assessed by preoperative and postoperative 3- and 12-month myocardial single photon emission computed tomography, and who showed all patent grafts on angiograms taken 1 year postoperatively were included. Myocardial single-photon emission computed tomography imaging was performed during stress and rest, and a 17-segment model was adopted for regional analysis of the perfusion defect. Myocardial segments were analysed based on a 5-point scale (0-4). After excluding the segments with normal stress scores, the difference scores (DSs) of the segments with impaired stress perfusion were calculated. The segments were divided into group P (DS ≤1) and group R (DS ≥2).
Results:
Of 2057 myocardial segments from 120 patients, a total of 761 segments [segment group P (n = 572) vs segment group R (n = 189)] with impaired stress perfusion were included in the final analyses. The stress scores tended to decrease in both groups after the operation, although the changes in the stress perfusion scores over time were more significant in group R than in group P. The differences in the rest scores between groups P and R tended to decrease during postoperative year 1. Although the preoperative DSs were significantly lower in group P than in group R, the differences between the groups became insignificant during postoperative year 1.
Conclusions:
Complete revascularization including myocardium with persistent perfusion defect should be considered when performing CABG.
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