Fluorodeoxyglucose uptake in dysfunctional myocardium subtended by an occluded coronary artery. Relation to dobutamine contractile reserve and Sestamibi uptake.
BACKGROUND
Myocardial segments with impaired function may have the potential for functional recovery. Augmented exogenous glucose uptake in relation to blood flow estimated by [2-18F]2-fluorodeoxyglucose (FDG) and positron emission tomography (PET) frequently indicates functional reversibility. The spectrum of FDG uptake levels in relation to Sestamibi uptake and dobutamine contraction reserve in areas with impaired function subtended by an occluded coronary artery has never been reported.


RESULTS
Seventeen patients with stable angina pectoris and dysfunctional myocardium subtended by an occluded coronary artery were studied with FDG-PET, low-dose dobutamine echocardiography and Sestamibi-Single Photon Emission Computerized Tomography. In a 16 segment model dysfunctional myocardial segments showed a normally distributed FDG uptake ranging from 34% to 150% when normalized to peak segmental Sestamibi uptake. Low FDG uptake was associated with both lack of dobutamine induced contractile reserve and low Sestamibi uptake (in 73% of the segments) whereas high FDG uptake displayed both contractile reserve and Sestamibi uptake (57%). Segments with intermediate FDG uptake had either contractile reserve or a preserved Sestamibi uptake (62%).


CONCLUSIONS
Dysfunctional myocardium subtended by an occluded coronary artery represents a continuum of metabolic states with a high degree of heterogeneity with regard to contractile reserve and Sestamibi uptake.
Kofoed
K F
KF
Medical Department B, Rigshospitalet, University of Copenhagen, Denmark. kkofoed@pet.rh.dk
Carstensen
S
S
Hesse
B
B
Hove
J D
JD
Holm
S
S
Jensen
M
M
Haunsø
S
S
Kelbaek
H
H
D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D004280:Dobutamine; D004452:Echocardiography; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D009206:Myocardium / Q000378:metabolism*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*
D002316:Cardiotonic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi