{ "abstract": "Background: In patients with ischemic cardiomyopathy (ICM), accurate preoperative identification of viable myocardium is clinically important to identify those who are likely to benefit from coronary artery bypass grafting (CABG). Although the PET perfusion–metabolism mismatch index has long been used to assess myocardial viability, its value in predicting contractile recovery remains controversial. Quantitative metabolic indices based on standardized uptake value (SUV) may provide complementary prognostic information. Methods: This single-center retrospective cohort study included 53 patients with ICM who underwent preoperative [13N]ammonia/[18F]FDG PET/CT followed by isolated CABG. Conventional perfusion–metabolism indices were compared with SUV-based indices. The evaluated outcomes were postoperative increases in left ventricular ejection fraction (ΔLVEF) of ≥5% and ≥10% on follow-up echocardiography, and time to first major adverse cardiovascular event (MACE). Each PET parameter was evaluated in a separate multivariable Firth-penalized logistic regression model adjusted a priori for age, baseline LVEF, history of coronary artery disease, and diabetes. The predictive performance was assessed by receiver operating characteristic analysis, and time to MACE by Cox regression with the adjustment of multiple testing and model optimism. Results: Of the 53 patients, 32 (60.4%) achieved ΔLVEF ≥5% and 25 (47.2%) achieved ΔLVEF ≥10%. The infarct-to-non-infarct SUV ratio (SUVR) was associated with ΔLVEF ≥5% (odds ratio [OR] 1.94 per 0.1-unit increase, 95% confidence interval [CI] 1.28–3.25; P < 0.001; q = 0.003) and ΔLVEF ≥10% (OR 1.53, 95% CI 1.11–2.29; P = 0.004; q = 0.035). For the prediction of ΔLVEF ≥5%, SUVR had a higher area under the curve (AUC) than the mismatch index (0.83 vs 0.62; DeLong P = 0.0049; q = 0.0147). For the prediction of ΔLVEF ≥10%, the AUCs did not differ (0.73 and 0.63; DeLong P = 0.200; q = 0.383). No individual PET parameter was associated with time to first MACE in adjusted Cox models. Conclusions: SUVR showed greater discrimination for postoperative ΔLVEF ≥5% than the conventional perfusion–metabolism mismatch index. This finding supports SUVR as a quantitative adjunct to conventional PET viability assessment and warrants further multicenter validation.", "abstract_shown": true, "affiliations": [ "Department of Nuclear Medicine, TEDA International Cardiovascular Hospital, Clinical College of Cardiovascular Diseases, Tianjin Medical University, Tianjin, China", "Nuclear Science and Engineering Institute, University of Missouri-Columbia, Columbia, Missouri, United States of America" ], "article_type": "Research Article", "arxiv": null, "author_total": 7, "authors": [ { "affs": [ 0 ], "name": "Fukai Zhao" }, { "affs": [ 1 ], "name": "Zekun Pang" }, { "name": "Haoran Guo" }, { "name": "Yue Chen" }, { "name": "Jiao Wang" }, { "name": "Bailing Hsu" }, { "name": "Jianming Li" } ], "bibtex": "https://research.draconitic.com/paper/ft4syrxth9jsr.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0358657", "fulltext_url": null, "id": "ft4syrxth9jsr", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0358657", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2741|Cardiac Imaging and Diagnostics" ], [ "plos", "/Biology and life sciences/Anatomy/Cardiovascular anatomy/Heart/Myocardium" ], [ "plos", "/Biology and life sciences/Neuroscience/Neuroimaging/Positron emission tomography" ], [ "plos", "/Medicine and health sciences/Anatomy/Cardiovascular anatomy/Heart/Myocardium" ], [ "plos", "/Medicine and health sciences/Cardiology/Cardiovascular medicine/Cardiovascular diseases/Coronary heart disease" ], [ "plos", "/Medicine and health sciences/Cardiology/Ejection fraction" ], [ "plos", "/Medicine and health sciences/Cardiology/Myocardial infarction" ], [ "plos", "/Medicine and health sciences/Diagnostic medicine/Diagnostic radiology/Tomography/Positron emission tomography" ], [ "plos", "/Medicine and health sciences/Diagnostic medicine/Diagnostic radiology/Ultrasound imaging/Echocardiography" ], [ "plos", "/Medicine and health sciences/Endocrinology/Endocrine disorders/Diabetes mellitus" ], [ "plos", "/Medicine and health sciences/Medical conditions/Cardiovascular diseases/Coronary heart disease" ], [ "plos", "/Medicine and health sciences/Medical conditions/Metabolic disorders/Diabetes mellitus" ], [ "plos", "/Medicine and health sciences/Radiology and imaging/Diagnostic radiology/Tomography/Positron emission tomography" ], [ "plos", "/Medicine and health sciences/Radiology and imaging/Diagnostic radiology/Ultrasound imaging/Echocardiography" ], [ "plos", "/Medicine and health sciences/Surgical and invasive medical procedures/Cardiovascular procedures/Coronary artery bypass grafting" ], [ "plos", "/Medicine and health sciences/Vascular medicine/Coronary heart disease" ], [ "plos", "/Research and analysis methods/Imaging techniques/Diagnostic radiology/Tomography/Positron emission tomography" ], [ "plos", "/Research and analysis methods/Imaging techniques/Diagnostic radiology/Ultrasound imaging/Echocardiography" ], [ "plos", "/Research and analysis methods/Imaging techniques/Neuroimaging/Positron emission tomography" ] ], "openalex": "W7213867937", "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0358657&type=printable", "pmcid": null, "pmid": null, "published": "2026-09-21", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/ft4syrxth9jsr.ris", "sources": [ { "first_seen": "2026-10-30T12:17:43Z", "native_id": "10.1371/journal.pone.0358657", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0358657" } ], "subjects": [ { "field": "medicine", "origin": "plos:cardiovascular diseases", "subfield": "cardiovascular" }, { "field": "medicine", "origin": "plos:diagnostic radiology", "subfield": "imaging" } ], "title": "Quantitative [¹³N]ammonia/[¹⁸F]FDG PET/CT predicts left ventricular functional recovery after CABG in ischemic cardiomyopathy: An exploratory study", "title_text": "Quantitative [¹³N]ammonia/[¹⁸F]FDG PET/CT predicts left ventricular functional recovery after CABG in ischemic cardiomyopathy: An exploratory study", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:43Z", "url": "https://research.draconitic.com/paper/ft4syrxth9jsr", "venue": "PLOS One", "versions": [] }