Efficacy and limitation of F-18-fluorodeoxyglucose positron emission tomography during fasting to assess myocardial viability in the acute phase of myocardial infarction.
OBJECTIVE
The present study was designed to determine the ability of positron emission tomography (PET) to assess myocardial viability and ischemia in acute myocardial infarction (MI) after reperfusion therapy (thrombolysis and/or coronary angioplasty).


METHODS
PET with fluorine-18-labeled fluorodeoxyglucose (FDG) under fasting conditions and thallium-201 single-photon emission computed tomography (TL) were analyzed in 21 patients one week following MI. Myocardial viability was also assessed by regional wall motion using serial analysis of 2-D echocardiography or left ventriculography.


RESULTS
Marked uptake of FDG together with a residual perfusion defect were observed in the infarct region in all patients one week post MI. However, in 9 of the 21 patients, the infarct-related coronary artery had no significant stenosis after reperfusion therapy and remained patent in one month post MI suggesting no myocardial ischemia. In contrast, in 4 of the 21 patients the regional wall motion was akinetic and there was a complete defect observed with TL imaging at one month post MI, indicating no viability in the infarct region.


CONCLUSIONS
PET using fasting FDG at one week post MI had a limitation to predict myocardial viability or ischemia.
Nonogi
H
H
Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka.
Miyazaki
S
S
Goto
Y
Y
Ishida
Y
Y
Uehara
T
T
Nishimura
T
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D004452:Echocardiography; D005215:Fasting; D005260:Female; D019788:Fluorodeoxyglucose F18; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D015425:Myocardial Reperfusion; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed / Q000379:methods*
D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18