Quantitative relation of myocardial infarct size and myocardial viability by positron emission tomography to left ventricular ejection fraction and 3-year mortality with and without revascularization

AbstractObjectives. The purpose of this study was to determine the clinical prognostic value, with and without revascularization, of the size of myocardial infarction and viability as measured by positron emission tomography (PET).Background. Poorly contracting but viable myocardium recovers contractile performance after revascularization. However, the quantitative relation among size of infarction and viability by PET, ejection fraction and long-term survival with and without revascularization in patients after myocardial infarction has not been previously reported.Methods. Infarct size and viability imaged by PET using generator-produced rubidium-82 were quantified objectively by automated software and related to coronary arteriography, left ventricular ejection fraction, revascularization and 3-year mortality.Results. Myocardial infarction or scar ≥23% of the left ventricle was associated with a 3-year mortality rate of 43% versus that of 5% associated with scar