Impaired myocardial microcirculation in the flow-glucose metabolism mismatch regions in revascularized acute myocardial infarction.
In successfully revascularized acute myocardial infarction (AMI), microvascular function in a myocardial flow-glucose metabolism mismatch pattern has not been reported. We aimed to elucidate myocardial flow reserve (MFR) and myocardial viability in mismatch segments.



18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and adenosine stress13N-ammonia PET were performed in eighteen AMI patients to evaluate myocardial glucose metabolism, myocardial blood flow (MBF), and MFR. Infarct segments were classified into 3 groups: normal (preserved resting MBF), mismatch (preserved FDG uptake but reduced resting MBF), and match (reduced FDG uptake and resting MBF). Regional wall motion score (WMS) was assessed immediately after reperfusion and recovery periods.



MFR in the mismatch group was significantly lower than that in non-infarct-related segments (1.655 ± 0.516 vs 2.282 ± 0.629, P < .01) and similar to that in the match group (1.635 ± 0.528, P = .999). WMS in the mismatch group was significantly improved (3.07 ± 0.48 vs 2.07 ± 1.14, P = .003); however, in recovery periods, WMS in the mismatch group was significantly higher than that in the normal group (1.05 ± 1.04, P < .01).



In successfully revascularized AMI, microvascular function is impaired despite preserved myocardial glucose metabolism in mismatch segments.
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Yoshitomo
Y
Fukuoka
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.|Division of Cardiology, Hikone Municipal Hospital, 1882 Hassakacho, Hikone, Shiga, 522-0057, Japan.
Akira
A
Nakano
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Naoto
N
Tama
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Kanae
K
Hasegawa
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Hiroyuki
H
Ikeda
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Tetsuji
T
Morishita
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Kentaro
K
Ishida
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Kenichi
K
Kaseno
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Naoki
N
Amaya
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan. huzui@u-fukui.ac.jp.
Hiroyasu
H
Uzui
Biomedical Imaging Research Center, Division of Medical Imaging, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Hidehiko
H
Okazawa
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Hiroshi
H
Tada
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D003326:Coronary Circulation; D005260:Female; D019788:Fluorodeoxyglucose F18; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009038:Motion; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000473:pathology*; D009590:Nitrogen Radioisotopes; D049268:Positron-Emission Tomography
D001786:Blood Glucose; D009590:Nitrogen Radioisotopes; C000615247:Nitrogen-13; D019788:Fluorodeoxyglucose F18
13N-ammonia PET; Flow-glucose metabolism mismatch; acute myocardial infarction; microcirculation