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Purpose <p>This study aimed to assess the predictive value of hibernating myocardium (HM) proportion in total perfusion deficit (TPD) for reverse left ventricular (LV) remodeling and its prognostic significance in heart failure with reduced ejection fraction (HFrEF) patients after revascularization.</p> Methods <p>A retrospective analysis of 201 HFrEF patients (178 males, 60.6 ± 9.3 years) who underwent gated myocardial perfusion imaging, <sup>18</sup>F-FDG cardiac PET/CT, and echocardiography was performed. Patients were followed for a median of 13.0(7.0) months and received follow-up echocardiography 6 months post-revascularization. Reverse remodeling (RR) was defined as ≥ 10% reduction in LV end-systolic diameter (LVESD). Logistic regression identified predictors of RR, with the predictive value of HM/TPD validated in a prospective cohort (<i>n</i> = 30). Changes were expressed as Δ(post-pre).</p> Results <p>HM/TPD independently predicted RR (OR = 1.042, 95%CI: 1.019–1.065, <i>P</i> &lt; 0.001). A HM/TPD cutoff of 38.5% demonstrated significant associations with reversed LV remodeling and improved cardiac function post-revascularization, along with a favorable prognosis. The prospective cohort validated these findings. ΔTPD positively correlated with ΔHM (<i>r</i> = 0.825, <i>P</i> &lt; 0.001).</p> Conclusions <p>Higher HM/TPD proportion in HFrEF patients was associated with an increased likelihood of RR, improved cardiac function, and favorable outcomes post-revascularization. These findings warrant further prospective investigations.</p>

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Predict value of ratio of hibernating myocardium in TPD on reverse remodeling and MACEs in HFrEF patients post-revascularization

  • 期刊论文

  • 发表日期：

    2025年10月3日

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  • Yao Lu,
  • Yanlin Wang,
  • Zihan Liu,
  • Jingjing Meng,
  • Mingkai Yun,
  • Ran Dong,
  • Xiaoli Zhang

摘要

Purpose

This study aimed to assess the predictive value of hibernating myocardium (HM) proportion in total perfusion deficit (TPD) for reverse left ventricular (LV) remodeling and its prognostic significance in heart failure with reduced ejection fraction (HFrEF) patients after revascularization.

Methods

A retrospective analysis of 201 HFrEF patients (178 males, 60.6 ± 9.3 years) who underwent gated myocardial perfusion imaging, 18F-FDG cardiac PET/CT, and echocardiography was performed. Patients were followed for a median of 13.0(7.0) months and received follow-up echocardiography 6 months post-revascularization. Reverse remodeling (RR) was defined as ≥ 10% reduction in LV end-systolic diameter (LVESD). Logistic regression identified predictors of RR, with the predictive value of HM/TPD validated in a prospective cohort (n = 30). Changes were expressed as Δ(post-pre).

Results

HM/TPD independently predicted RR (OR = 1.042, 95%CI: 1.019–1.065, P < 0.001). A HM/TPD cutoff of 38.5% demonstrated significant associations with reversed LV remodeling and improved cardiac function post-revascularization, along with a favorable prognosis. The prospective cohort validated these findings. ΔTPD positively correlated with ΔHM (r = 0.825, P < 0.001).

Conclusions

Higher HM/TPD proportion in HFrEF patients was associated with an increased likelihood of RR, improved cardiac function, and favorable outcomes post-revascularization. These findings warrant further prospective investigations.