Recovery of perfusion, glucose utilization and fatty acid utilization in stunned myocardium.
We describe the clinical features and results of cardiac catheterization, PET ([13N]ammonia, 18F-fluorodeoxyglucose (FDG)) and SPECT [123I-labeled 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP)], in a patient with acute myocardial infarction successfully treated with intracoronary thrombolytic therapy. We compared the clinical and electrocardiographic changes with the myocardial glucose and fatty acid metabolism in stunned myocardium over a period of several months. The patient we studied illustrates the features of stunned myocardium. In the subacute phase, there was a concordant depression of myocardial [13N]ammonia and FDG uptake, and the metabolic abnormalities persisted even after regional wall motion at rest had returned to normal. The electrocardiographic recovery of deep negative T waves appeared to be related to the metabolic recovery in regions of stunned myocardium in this patient.
Tsubokawa
A
A
First Department of Internal Medicine, Biomedical Imaging Research Center, Fukui, Japan.
Lee
J D
JD
Shimizu
H
H
Nakano
A
A
Uzui
H
H
Takeuchi
M
M
Tsuchida
T
T
Yonekura
Y
Y
Ishii
Y
Y
Ueda
T
T
D000641:Ammonia; D006328:Cardiac Catheterization; D004562:Electrocardiography; D005227:Fatty Acids / Q000378:metabolism; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000378:metabolism*; D009206:Myocardium / Q000378:metabolism*; D009590:Nitrogen Radioisotopes; D010960:Plasminogen Activators / Q000627:therapeutic use; D019275:Radiopharmaceuticals; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon
D005227:Fatty Acids; D005462:Fluorine Radioisotopes; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D009590:Nitrogen Radioisotopes; D019275:Radiopharmaceuticals; C049338:iodofiltic acid; D019788:Fluorodeoxyglucose F18; D000641:Ammonia; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator; D005947:Glucose