Metabolic imaging in myocardial ischemia and heart failure.
Myocardial ischemia and heart failure are accompanied by well characterized changes in myocardial substrate metabolism. While the normal heart in the fasting state mostly relies on oxidation of fatty acids for energy production, acute myocardial ischaemia is accompanied by increased exogenous myocardial glucose uptake and suppressed utilization of fatty acids. This metabolic shift can be detected using metabolic imaging using labeled glucose and fatty acid analogs. Recently, also specific tracers for the detection of myocardial hypoxia have been tested. In the assessment of myocardial viability metabolic imaging has an established role. Metabolic imaging has also greatly improved our understanding about metabolic derangements in the failing heart and currently metabolic modulation as a therapy of heart failure is studied. While experimental and clinical results are promising, larger clinical trials are warranted to better understand the value of metabolic imaging in the detection and prognosis of ischemic heart disease.
Knuuti
J
J
Turku PET Centre, University of Turku, Turku, Finland. uhani.knuuti@utu.fi
Tuunanen
H
H
D005230:Fatty Acids, Nonesterified / Q000378:metabolism*; D005947:Glucose / Q000378:metabolism*; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism*; D010084:Oxidation-Reduction; D010101:Oxygen Consumption; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon
D005230:Fatty Acids, Nonesterified; D019275:Radiopharmaceuticals; D005947:Glucose