Application of adenosine stress-rest gated myocardial perfusion imaging in evaluation of patients with multivessel coronary artery disease after coronary artery bypass grafting
Objective To explore the utility of adenosine stress-rest gated myocardial perfusion im-aging(G-MPI)in evaluation of left ventricular(LV)myocardial perfusion,heart function,and synchroni-zation in patients with multivessel coronary artery disease after coronary artery bypass grafting(CABG).Methods Fifty-five patients(42 males,13 females,age(59.3±9.0)years)with multivessel coronary ar-tery disease who underwent CABG surgery in Yan'an Hospital Affiliated to Kunming Medical University be-tween January 2021 and June 2023 were retrospectively collected.All of them underwent G-MPI(one-day method)one week before and six months after CABG.Paired t-test or Wilcoxon signed rank test was used to compare LV myocardial perfusion parameters including summed stress score(SSS),summed rest score(SRS),and summed different score(SDS)before and after CABG,as well as cardiac function parameters(LV ejection fraction(EF),LV end-diastolic volume(EDV),LV end-systolic volume(ESV),stroke vol-ume(SV),peak filling rate(PFR)),and LV mechanical contraction synchronization parameters such as phase histogram bandwidth(PHB)and phase standard deviation(PSD).Differences of the changes of pa-rameters after CABG compared to baseline(△)between adenosine stress imaging and rest imaging were also compared by Wilcoxon signed rank test.The relationships between rest LVEF,rest PFR and myocardial per-fusion parameters were analyzed by Spearman rank correlation analysis.Results After CABG,the SSS,SRS,and SDS were significantly lower than those before surgery(6(3,12)vs 16(9,23),1(0,9)vs 4(1,15),3(1,5)vs 8(6,12);z values:6.37,4.84,6.24,all P＜0.001);postoperative rest/stress LVEF(60％(49％,67％),58％(48％,68％))and PFR(3.67(3.12,4.28),3.23(2.77,4.43)EDV/s)signifi-cantly increased compared with preoperative values(51％(33％,62％),53％(27％,61％);2.76(2.08,3.52),2.83(1.86,3.62)EDV/s;z values:3.23-5.58,all P＜0.01);postoperative rest/stress LVEDV and LVESV were significantly lower than those before surgery(t values:6.40,5.27;z values:5.33,5.40;allP＜0.001);rest/stress PHB(45°(35°,70°),53°(44°,113°))and PSD(14.7°(10.9°,27.3°),20.0°(14.6°,33.8°))were significantly lower than those before surgery(60°(45°,131°),83°(58°,198°),20.4°(16.0°,49.1°),27.2°(19.6°,60.4°);z values:4.19-4.81,all P＜0.001).The △SSS was greater than the △SRS,and the △PFR was greater in rest imaging than that in stress imaging(z values:6.24,2.77,both P＜0.05).Rest LVEF,PFR were negatively correlated with SSS and SRS(rs values:from-0.741 to-0.431,all P＜0.05).Conclusion The LV myocardial perfusion,function,and mechanical contraction synchronicity information obtained from adenosine stress-rest G-MPI can be used to evaluate the recovery af-ter CABG,which may help to better identify patients who may have adverse cardiac events.
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