Introduction: The advent of high resolution multidetector computed tomography (MDCT) created the potential to quantify myocardial blood flow (MBF) reduction. The effect in regional MBF produced by coronary artery bypass grafting has not been quantitatively evaluated. The purpose of this study was to test the hypothesis that adenosine stress/rest MDCT can detect ischemia by measuring MBF differences in pre- versus post-CABG patients.
Methods: Ninety regional areas in 10 patients (median age 71; 65–79, 7 males), scheduled for CABG at our institution, were studied. Each patient underwent adenosine stress 64-slice MDCT perfusion imaging in both pre- and postoperative period. Myocardial blood flow was calculated with Patlak plots analysis. Regional left ventricular function (LVF) was assessed by Echocardiography.
Results: Preoperative mean MBF in ischemic and non-ischemic areas was 0.76±0.49 (ml/g/min) and 2.15±0.66, respectively (p<0.05). Postoperative MBF increased to 1.40±0.77 (ml/g/min) in ischemic areas (p<0.05), though the non-ischemic area showed no differences. The degree of ischemia on MDCT was correlated to change in regional LVF. Postoperative assessment revealed the improved regional LVF that was correlated with the increase in regional MBF.
Conclusions: The regional MBF can be quantitatively assessed by adenosine stress 64-slice MDCT perfusion imaging. This technique provides quantitative information about regional MBF in pre- and post- CABG patients, which may predict the regional LVF recovery after CABG.
Reversible Cardiac Sympathectomy by High Thoracic Epidural Anesthesia Improves Regional Left Ventricular Function in Patients Undergoing Coronary Artery Bypass Grafting
