title: Evidence of reverse mismatch with positron emission tomography imaging in a patient with reversible myocardial dysfunction.
abstract: We describe the case of a patient who came to our attention because of a reversible depression of myocardial contractility, probably due to myocarditis. A positron emission tomography study showed, in correspondence to the malfunctioning segments, a decreased F18-2-fluoro-2-deoxyglucose (F18-FDG) uptake in the presence of a normal perfusion as assessed by means of N13-labeled ammonia uptake. This phenomenon, called "reverse mismatch", shows that viability is not always dependent on FDG uptake and that it could be associated with the recovery of myocardial contractility. Some interpretations of the association between a reversible dysfunction and a reduced myocardial glucose metabolism are presented. The central role of nitric oxide and of cyclic guanosine monophosphate is hypothesized to explain both the mechanical and metabolic abnormalities.
authors.affiliation: Division of Cardiology, San Giacomo Hospital, Italy. rterlizzi@cardionet.it
authors.forename: Raffaele
authors.initials: R
authors.lastname: Terlizzi
authors.forename: Gianleone
authors.initials: G
authors.lastname: Suzzi
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Zanco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Candelpergher
authors.forename: Diego
authors.initials: D
authors.lastname: Vaccari
authors.forename: Alessandro
authors.initials: A
authors.lastname: Costa
authors.forename: Marco
authors.initials: M
authors.lastname: Franceschini
authors.forename: Lucia
authors.initials: L
authors.lastname: Neri
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Celegon
authors.forename: Franca
authors.initials: F
authors.lastname: Chierichetti
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism; D014055:Tomography, Emission-Computed; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D019788:Fluorodeoxyglucose F18