QUANTITATIVE PET/CT FOR MYOCARDIAL VIABILITY ASSESSMENT AFTER COMPLEX PCI: EXPLORING THE ROLE OF MICROBIAL INFECTIONS AND INFLAMMATORY BIOMARKERS
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Keywords
Myocardial viability, PET/CT, PCI, CRP, IL-6, microbial infection, inflammation, cardiac recovery
Abstract
To assess myocardial viability using quantitative PET/CT in patients following complex PCI and explore the role of microbial infections and inflammatory biomarkers in predicting myocardial recovery.
Methods: This prospective study included 71 patients who underwent complex PCI at Ayub Teaching Hospital, Abbottabad, between January 2023 and January 2024. PET/CT using 18F-FDG was performed post-PCI to evaluate myocardial viability. Blood samples were collected to analyze inflammatory biomarkers including CRP and IL-6. Microbial infection status was also assessed. Follow-up echocardiography was used to evaluate myocardial recovery.
Results: The majority of patients demonstrated viable myocardium on PET/CT imaging, with 60% of the cohort showing functional myocardial improvement on follow-up. Inflammatory biomarkers, including CRP and IL-6, were moderately elevated in several patients; however, statistical analysis revealed no significant association between these markers and myocardial recovery (p > 0.05). Infection was identified in nearly one-third of the patients. Among those with positive findings, Chlamydia pneumoniae was the most frequently detected organism (n = 15), followed by Helicobacter pylori (n = 11) and Cytomegalovirus (n = 4). Despite the presence of these pathogens, no statistically significant correlation was found between infection status or specific microbial species and myocardial recovery outcomes. The majority of patients (n = 41) had no detectable infection. These findings suggest that neither systemic inflammation nor underlying chronic infections had a measurable impact on post-PCI myocardial functional improvement in this study population.
Conclusion: Quantitative PET/CT proved to be a reliable imaging tool for assessing myocardial viability following complex PCI. Although inflammatory markers and microbial infections were prevalent among patients, their presence did not significantly influence myocardial recovery. This underscores the importance of direct metabolic myocardial assessment through PET/CT over reliance on systemic biomarkers or infection status when evaluating viability and guiding post-revascularization care.
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Dr Hazrat Ullah Khan
Assistant Professor Department of Cardiology, Ayub Teaching Hospital, Abbottabad, Pakistan
Dr Muhammad Umer Khan Khalil
Senior Registrar, Department of Radiology, Northwest School of Medicine, Peshawar, Pakistan
Dr Rashid Iqbal
Senior Registrar, Department of Cardiology, Saidu Group of Teaching Hospital, Swat, Pakistan
Dr Zubeda Irshad
Assistant Professor Microbiology, Pathology Department, Burns and Plastic Surgery Center, MTI-HMC, Peshawar, Pakistan
Dr Rakhshanda Naheed
Assistant Professor, Department of Physiology LMCL- Loralai Medical College, Loralai, Balochistan, Pakistan