OBJECTIVE: To evaluate the influence of the myocardium viability study by coincidence imaging using 18F-FDG in the clinical decision-making of patients with ischemic cardiomyopathy and left ventricular dysfunction. METHODS: Thirty-one patients were submitted to myocardial viability study with 18F-FDG by coincidence imaging between September 2003 and November 2004. The physician answered a questionnaire about the choice of therapeutic procedure before and after PET. RESULTS: Twenty-seven patients (87%) had myocardial viability. Twenty-one (68%) physicians thought that PET changed the therapeutic procedure for their patients and 27(87%) considered that PET added to the therapeutic decision. The current treatment decision (clinical or revascularization) correlated with myocardial viability (p=0.006). CONCLUSIONS: Coincidence imaging is a useful tool to help physicians in a difficult decision about the best treatment for patients with ischemic cardiomyopathy. Symptoms, electrocardiogram, ejection fraction and myocardial fibrosis area did not correlate with myocardium viability, so they should not be used to decide whether to perform a myocardial viability study or not.
Ischemic cardiomyopathy; myocardial viability; PET; coincidence system
