A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree
of Master of Medicine.
Johannesburg, October 2017. / Background: Positron Emission Tomography (PET) is an imaging modality that
guides the revascularization management of patients with left ventricular systolic
dysfunction secondary to coronary artery disease. Segments of the myocardium
demonstrating reduced perfusion and increased or preserved 18FFluorodeoxyglucose
(18F-FDG) uptake are considered to be viable and thus suitable
for revascularization. The aim of our study was to determine the prevalence of
myocardial viability as determined by FDG-PET in our local cohort and to compare
our prevalence of myocardial viability to data published elsewhere.
Methods: We retrospectively reviewed 240 consecutive 99mTc-sestamibi
myocardial perfusion Gated Single Photon Emission Tomography (SPECT) and 18FFDG
PET reports of patients referred for evaluation of myocardial viability between
January 2009 and June 2015.
Results: 236 patients met the inclusion criteria. There were 194 (82.2%) males.
The mean age was 59.1 (SD 11.0) years. A total of 4012 segments of the left
ventricle were analyzed on the gated SPECT and reduced perfusion was noted in
1862 (46.4%) segments. Perfusion-metabolism mismatch (viable myocardium) was
observed in 586 (31.5%) out of 1862 perfusion defects. The prevalence of
myocardial viability in the study population was 61.4%. On the multivariate logistic
regression model, aspirin intake [OR:0.37; CI:0.16-0.83; p=0.016] and hypertension
[OR:0.26; CI:0.12-0.58; p=0.001] were associated with the presence of viable
myocardium. Smoking was associated with the likelihood of having non-viable
myocardium [OR:2.31; CI:1.01-5.29; p=0.048]
Conclusion: The prevalence of myocardial viability as detected by 18F FDG PET in
our local cohort is similar to prevalence rates reported in the developed world. / LG2018
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/25526 |
| Date | January 2017 |
| Creators | Mpanya, Dineo |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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