title: Altered myocardial glucose utilization and the reverse mismatch pattern on rubidium-82 perfusion/F-18-FDG PET during the sub-acute phase following reperfusion of acute anterior myocardial infarction.
abstract: BACKGROUND
  Reperfused myocardium post-acute myocardial infarction (AMI) may have altered metabolism with implications for therapy response and function recovery. We explored glucose utilization and the "reverse mismatch" (RMM) pattern (decreased F-18-fluorodeoxyglucose (FDG) uptake relative to perfusion) in patients who underwent mechanical reperfusion with percutaneous coronary intervention (PCI) for AMI.
  
  
  RESULTS
  Thirty-one patients with anterior wall AMI treated with acute reperfusion, with left ventricular ejection fraction ≤45%, underwent rest rubidium-82 (Rb-82) and FDG PET 2-10 days post-AMI. Resting echocardiograms were used to assess wall motion abnormalities. Significant RMM occurred in 15 (48%) patients and was associated with a shorter time to PCI of 2.9 hours (2.2, 13.3 hours) compared to patients without significant RMM: 11.4 hours (3.9, 22.4 hours) (P = .03). Within the peri-infarct regions, segments with significant RMM were more likely to have wall motion abnormalities (OR = 2.3 (1.1, 4.7), P = .02) compared to segments without significant RMM.
  
  
  CONCLUSIONS
  RMM is a common pattern on perfusion/FDG PET during the sub-acute phase following reperfusion of AMI and is associated with shorter times to PCI. Within the peri-infarct region, RMM occurs frequently and is more often associated with wall motion abnormalities than segments without RMM. Whether this represents a myocardial metabolic shift during the sub-acute phase of recovery warrants further study.
authors.affiliation: Division of Cardiology, Department of Medicine, and the Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, Suite 3406, 40 Ruskin St., Ottawa, ON, K1Y 4WY, Canada.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Anselm
authors.forename: Anjali H
authors.initials: AH
authors.lastname: Anselm
authors.forename: Jennifer
authors.initials: J
authors.lastname: Renaud
authors.forename: Harold L
authors.initials: HL
authors.lastname: Atkins
authors.forename: Robert
authors.initials: R
authors.lastname: de Kemp
authors.forename: Ian G
authors.initials: IG
authors.lastname: Burwash
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Williams
authors.forename: Ann
authors.initials: A
authors.lastname: Guo
authors.forename: Cathy
authors.initials: C
authors.lastname: Kelly
authors.forename: Jean
authors.initials: J
authors.lastname: Dasilva
authors.forename: Rob S B
authors.initials: RS
authors.lastname: Beanlands
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Glover
mesh_terms: D003324:Coronary Artery Disease / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000378:metabolism*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000378:metabolism*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes; D018487:Ventricular Dysfunction, Left / Q000378:metabolism
chemical_list: D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes; D019788:Fluorodeoxyglucose F18; D005947:Glucose