Dobutamine-stress electrocardiographically gated positron emission tomography for detection of viable but dysfunctional myocardium.
OBJECTIVE
This study was performed to determine whether low-dose dobutamine stress electrocardiography (ECG)-gated fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET) can assess wall motion and identify myocardium without contractile reserve despite preserved FDG uptake.


METHODS
Fifty-three patients with myocardial infarction and normal sinus rhythm underwent ECG-gated FDG-PET and transthoracic echocardiography. Wall motion of 10 segments of the left ventricle was graded as normal, hypokinetic, or akinetic/dyskinetic.


RESULTS
In 365 (76%) of 480 segments, assessment of wall motion was concordant between the 2 modalities. In 30 patients dobutamine-stress ECG-gated FDG-PET was performed. In 13 (50%) of 26 dysfunctional segments with normal FDG uptake, 16 (36%) of 44 dysfunctional segments with mildly reduced FDG uptake and 12 (25%) of 48 dysfunctional segments with moderately reduced FDG uptake, wall motion was improved by dobutamine infusion.


CONCLUSIONS
Assessment of left ventricular wall motion with ECG-gated FDG-PET is feasible, and dobutamine stress ECG-gated FDG-PET can simultaneously identify metabolic viability and contractile reserve.
Yamagishi
H
H
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan. hiroyuki@msic.med.osaka-cu.ac.jp
Akioka
K
K
Hirata
K
K
Sakanoue
Y
Y
Toda
I
I
Yoshiyama
M
M
Teragaki
M
M
Takeuchi
K
K
Yoshikawa
J
J
Ochi
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004280:Dobutamine; D004452:Echocardiography; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014022:Tissue Survival; D014055:Tomography, Emission-Computed; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D019788:Fluorodeoxyglucose F18; D004280:Dobutamine