Formal assessment of myocardial viability (MV) is challenging in acute myocardial infarction-related cardiogenic shock (AMI-CS) patients receiving Impella mechanical circulatory support, as the cardiac magnetic resonance gold standard technique is not feasible due to the metallic components of the device. 18-fluorodesoxyglucose metabolic myocardial positron emission tomography (18FDG-PET) may represent a valid and feasible alternative to obtain semi-quantitative and objective evidence of MV during Impella support. We hereby report the first series of sequential AMI-CS patients who received 18FDG-PET scanning to assess MV during Impella support to demonstrate the safety and feasibility of this approach. In this cohort no adverse events occurred during 18FDG-PET scans, and all images were of excellent quality. This study provides a pragmatic guidance on how to perform this imaging modality during Impella support and finally confirms the safety and feasibility of this advanced imaging method also in this vulnerable cohort of patients.

Myocardial viability assessment during Impella support with 18-fluorodesoxyglucose PET imaging / Baldetti, L.; Busnardo, E.; Pazzanese, V.; Ricchetti, G.; Barone, G.; Sacchi, S.; Calvo, F.; Gramegna, M.; Pieri, M.; Ingallina, G.; Camici, P. G.; Ajello, S.; Scandroglio, A. M.. - In: ESC HEART FAILURE. - ISSN 2055-5822. - 12:1(2025), pp. 683-687. [10.1002/ehf2.15053]

Myocardial viability assessment during Impella support with 18-fluorodesoxyglucose PET imaging

Ricchetti G.;Pieri M.;Camici P. G.;
2025-01-01

Abstract

Formal assessment of myocardial viability (MV) is challenging in acute myocardial infarction-related cardiogenic shock (AMI-CS) patients receiving Impella mechanical circulatory support, as the cardiac magnetic resonance gold standard technique is not feasible due to the metallic components of the device. 18-fluorodesoxyglucose metabolic myocardial positron emission tomography (18FDG-PET) may represent a valid and feasible alternative to obtain semi-quantitative and objective evidence of MV during Impella support. We hereby report the first series of sequential AMI-CS patients who received 18FDG-PET scanning to assess MV during Impella support to demonstrate the safety and feasibility of this approach. In this cohort no adverse events occurred during 18FDG-PET scans, and all images were of excellent quality. This study provides a pragmatic guidance on how to perform this imaging modality during Impella support and finally confirms the safety and feasibility of this advanced imaging method also in this vulnerable cohort of patients.
2025
Acute coronary syndrome
Acute myocardial infarction
Cardiogenic shock
Impella
Myocardial metabolic PET
Myocardial recovery
Myocardial viability
Positron emission tomography
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/179336
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