| Objective To investigate the application value of 13N-NH3 ? H2O/18F-FDG PET/CT myocardial perfusion-metabolic imaging in the evaluation of cardiac function improvement after coronary artery bypass grafting.Method A total of 30 patients who underwent coronary artery bypass grafting in the Department of Cardiac Surgery of the Affiliated Hospital of Inner Mongolia Medical University from July 2019 to December 2022 were collected,and > before and after surgery The relevant data were obtained by 13N-NH3 ? H2O/18F-FDG PET/CT for 3 months,and the changes and consistency of LVEF,EDV,ESV,number of surviving myocardium and number of infarcted myocardium before and after CABG were analyzed by paired t-test and kappa test.According to whether the postoperative LVEF improved(the increase in LVEF after surgery was judged to be an improvement of 5% or more),it was divided into △ LVEF ≥5% group and△LVEF <5% group.Independent sample t-test was used to analyze the differences in relevant clinical indicators of △LVEF ≥5% group and △LVEF <5% group,and the independent influencing factors of LVEF improvement after CABG were analyzed by including age,sex,height,weight and other binary multivariate logistic regression equations.ROC curve analysis predicts the cut-off value of preoperative surviving myocardial number to predict LVEF improvement after CABG surgery.Results There were significant differences in LVEF,EDV,ESV,surviving myocardial number,and infarcted myocardial number before and after CABG(P<0.05).Among the 30 patients who underwent CABG,20 had a decrease in left ventricular volume and 10 had no decrease in left ventricular volume.19 LVEF improved,11 LVEF did not.In 43.33%(13/30)of patients with coronary heart disease who underwent CABG,the improvement of LVEF was inconsistent with the change of left ventricular volume,and the consistency between the two was poor(Kappa=0.049).The difference between the LVEF-improvement group and the LVEF-no improvement group before surgery,the number of normal myocardium before surgery,and the number of surviving myocardium were statistically significant(P<0.05).Compared with the LVEF-improved group,the number of surviving myocardium increased significantly compared with the LVEF-not improved group[21(12,30)and 6(6,9),P<0.05],while there was no significant difference in other indicators between the two groups(P>0.05).The results of binary multivariate logistic regression equation showed that preoperative LVEF(B=-0.130,OR=4.271),preoperative normal myocardial number(B=-0.137,OR=6.635)and preoperative surviving myocardial number(B=0.124,OR=5.456,)were independent influencing factors that led to the improvement of LVEF in patients with coronary heart disease after CABG.The ROC curve showed that the number of surviving myocardium before surgery predicted the improvement of LVEF after CABG was 10.5%,the area under the curve was 0.758,the sensitivity was 78.9%,and the specificity was 81.8%.Conclusion GABG can significantly improve the patient’s cardiac function,reverse ventricular remodeling,and can be used as an effective means to relieve symptoms,prevent myocardial infarction,and prolong survival.LVEF does not necessarily improve at the same time as left ventricular volume,and the consistency between the two is poor.Preoperative surviving myocardial number,normal myocardial number,and preoperative LVEF were independent influencing factors that led to the improvement of LVEF in patients with coronary heart disease after CABG surgery.It can accurately predict the improvement of left ventricular ejection fraction after CABG surgery,and the number of surviving myocardial needs to be greater than10.5%.13N-NH3?H2O/18F-FDG PET/CT myocardial metabolic imaging to evaluate the surviving myocardium and its number is of great significance for predicting the improvement of cardiac function after CABG surgery. |
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