The assessment of myocardium viability in patients with chronic occlusion of coronary arteries: the comparative analyses of the positron emission and magnetic resonance tomography

The aim: Integrated assessment of perfusion, metabolism, scar tissue extension and regional contractility in the myocardium subtended by chronic totally occluded (CTO) coronary arteries using 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG-PET) and Contrast Enhanced Cardiovascular Magnetic Resonance Imaging (ceCMR). Methods: We studied thirty four patients with chronic coronary artery disease and angiographycally proven CTO coronary arteries. Myocardial tissue perfusion, regional wall motion and the volume of scar tissue extension were assessed with ceCMR. We evaluated myocardial viability with PET images according to segmental 18F-FDG uptake. Results: High agreement between contrast-enhanced MRI and nuclear imaging was observed in segments with transmural scar on contrast-enhanced MRI (77%). We found higher level of coincidence between two methods for segments with akinesis, rather for segments with hypokinesis (91.6 against 43.5%). Inverse correlation between scar tissue volume and glucose uptake was established (r=-0.75; p