A reverse flow-metabolism mismatch pattern: a new marker of viable myocardium with greater contractility during dobutamine stress than myocardium with a flow-metabolism mismatch pattern.
Few studies have investigated the contractility of myocardium with a reverse flow-metabolism pattern; that is, greater uptake of nitrogen- 13-ammonia (NH3) than fluorine- 18-fluorodeoxyglucose (FDG) on positron emission tomography (PET). This study examined the contraction thickening represented by count increase in ECG-gated FDG-PET of myocardium with a reverse flow-metabolism pattern during low-dose dobutamine stress. Fifty-four patients with myocardial infarction were studied. Relative NH3 and FDG uptake (%NH3, %FDG) and %count increase were measured in 216 apical and 216 lateral segments on ECG-gated FDG-PET. The %count increase during low-dose dobutamine stress was greater in myocardium with a reverse flow-metabolism mismatch pattern than in myocardium with a flow-metabolism mismatch pattern (35.9+/-25.7% vs 24.6+/-15.9%, p=0.0221 in apical segments, and 38.4+/-22.6% vs 27.6+/-18.4%, p=0.0040 in lateral segments) despite smaller %FDG. A reverse flow-metabolism mismatch pattern should be noted as a new marker of viable myocardium with greater contractility during dobutamine stress than myocardium with a flow-metabolism mismatch pattern.
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
D000368:Aged; D000641:Ammonia / Q000493:pharmacokinetics; D015415:Biomarkers; D015331:Cohort Studies; D003326:Coronary Circulation; D004280:Dobutamine / Q000494:pharmacology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects / Q000502:physiology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D009587:Nitrogen Isotopes; D019275:Radiopharmaceuticals; D012039:Regional Blood Flow; D014055:Tomography, Emission-Computed / Q000379:methods
D015415:Biomarkers; D009587:Nitrogen Isotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D004280:Dobutamine; D000641:Ammonia