Comparison of Myocardial Perfusion Scintigraphy Before and After Coronary Bypass Surger

Asad Malik; Fida Hussain; Aleena Tariq; Muhammad Adil; Mehmood Hussain; Zeeshan Sikandar

doi:10.51253/pafmj.v75i3.8667

Authors

Asad Malik Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Fida Hussain Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Aleena Tariq Department of Nuclear Medicine, Rawalpindi Institute of Cardiology, Rawalpindi Pakistan
Muhammad Adil Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Mehmood Hussain Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Zeeshan Sikandar Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i3.8667

Keywords:

Coronary Artery Disease, Myocardial Perfusion Scintigraphy, Wall Motion.

Abstract

Objective: To study the change in left ventricular perfusion as well as functional parameters before and after Coronary Artery Bypass Grafting (CABG) using myocardial perfusion scintigraphy.

Study Design: Prospective observational study.

Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi, from Feb 2019 to Jan 2022.

Methodology: A total of 42 patients, scheduled for CABG, underwent myocardial perfusion scintigraphy (MPS) using 99mTc-sestamibi, before and 8-12 weeks after surgery. Pre and post operatively, left ventricular relative perfusion and functional parameters were analyzed using commercially available software by two independent nuclear physicians.

Results: Among the enrolled patients (n=42), 38(90.5%) were male while 4(9.5%) were female with mean age of 61.04±8.82 years. Left ventricular ejection fraction improved and was found to be statistically significant (38.93±8.19 to 46.26±10.46, p-value <0.01). Similarly, wall motion increased significantly in anterior and lateral segments with concomitant decrease in septal wall motion. A correlation was observed post-operatively between change in ejection fraction and wall motion (r=0.76) while significantly improved post-CABG radiotracer uptake was seen in almost all myocardial segments which showed reversible ischemia with resting perfusion ≥50% in 97 segments with fixed perfusion defects on pre-CABG resting perfusion, but ≤50% did not show any significant improvement, while 5 segments with pre-CABG resting perfusion ≤50% showed improvement on post-CABG MPS.

Conclusion: There is significant improvement in left ventricular perfusion and functional parameters after CABG as assessed by myocardial perfusion scintigraphy.

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