Myocardial perfusion and glucose uptake coupling in CAD patients.
OBJECTIVE
To evaluate coronary artery disease (CAD) patients regarding to their perfusion-glucose uptake relationship at rest for all myocardial regions and to determine whether this evaluation could typify patients with different positron emission tomography (PET)-pattern proportions and pathophysiological characteristics.


METHODS
Rest/dipyridamole H(15)2O and 18FDG PET studies were performed in 23 patients with left ventricular dysfunction. Regional index (relative perfusion, %H(15)2O; relative glucose uptake, %18FDG) allowed to detect PERFUSION-metabolism mismatch (i.e. hibernation) and dipyridamole-induced reversible stress defects (RSD).


RESULTS
The correlation (r) between %H(15)2O and % 18FDG at rest allowed definition of three groups: correlated (CORR; r > 0.7; n = 10), semicorrelated (SEMI; 0.5 < r < or = 0.7; n = 6) and uncorrelated (UNCO; r < or = 0.5; n = 7). In UNCO, 96% of regions had a %H(15)2O > or = 55% (p < 0.01 vs. 89 and 82% in SEMI and CORR) and 95% of regions had a %18FDG > or = 55% (p < 0.01 vs. 78 and 71% in SEMI and CORR). Mismatch proportions increased from CORR to SEMI and UNCO (11, 19 and 27%; p < 0.02) and proportion of regions with RSD was higher in UNCO and SEMI (25 and 24 vs. 6% in CORR; p < 0.01). Proportion of mismatch with RSD was at least three fold higher in UNCO (17/58) (p < 0.01 vs. 3/33 and 1/16 in SEMI and CORR).


CONCLUSIONS
Analysis of perfusion and glucose uptake at rest allowed to typify three categories of CAD patients with different PET-patterns proportions, distinctive ranges of perfusion and glucose uptake and distinctive hyperemic response. Our results suggest that myocardial hibernation associated with defective hyperemic response is specific of patients with preserved perfusion and glucose uptake.
Mazzadi
Alejandro N
AN
Centre d'Exploration et Recherche Médicale par Emission de Positons, Lyon, France. alejandro.mazzadi@cermep.fr
Croisille
Pierre
P
André-Fouët
Xavier
X
Fol
Stéphane
S
Duisit
Jérôme
J
Ovize
Michel
M
Comar
Dominique
D
Janier
Marc F
MF
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D004176:Dipyridamole; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D019788:Fluorodeoxyglucose F18; D015309:Glucose Clamp Technique; D006801:Humans; D006946:Hyperinsulinism / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D019275:Radiopharmaceuticals; D012146:Rest / Q000502:physiology; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013318:Stroke Volume / Q000502:physiology; D014055:Tomography, Emission-Computed; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology
D015415:Biomarkers; D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D019788:Fluorodeoxyglucose F18; D004176:Dipyridamole