Fluorodeoxyglucose uptake in dysfunctional myocardium subtended by an occluded coronary artery : Relation to dobutamine contractile reserve and Sestamibi uptake

• Published in: International journal of cardiac imaging Vol. 14; no. 2; pp. 97 - 104
• Main Authors: KOFOED, K. F, CARSTENSEN, S, HESSE, B, HOVE, J. D, HOLM, S, JENSEN, M, HAUNSØ, S, KELBAEK, H
• Format: Journal Article
• Language: English
• Published: Dordrecht Kluwer 01.04.1998
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Cardiotonic Agents; Coronary Disease - complications; Coronary Disease - diagnosis; Coronary Disease - metabolism; Coronary heart disease; Dobutamine; Echocardiography; Female; Fluorodeoxyglucose F18 - pharmacokinetics; Heart; Heart - diagnostic imaging; Humans; Male; Medical sciences; Middle Aged; Myocardial Contraction - drug effects; Myocardium - metabolism; Radiopharmaceuticals - pharmacokinetics; Technetium Tc 99m Sestamibi - pharmacokinetics; Tomography, Emission-Computed, Single-Photon; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - metabolism; Radionuclide study; Sonography; Human; Pharmacologic test; Cardiotonic agent; Echocardiography; Prognosis; Coronary artery; Dobutamine; Cardiovascular disease; Coronary heart disease; Arterial disease; Vascular disease; Myocardium; Obliteration; Viability; Positron; Emission tomography
• ISSN: 0167-9899; 1573-0743
• DOI: 10.1023/A:1005913113840

Myocardial segments with impaired function may have the potential for functional recovery. Augmented exogenous glucose uptake in relation to blood flow estimated by [2-18F]2-fluorodeoxyglucose (FDG) and positron emission tomography (PET) frequently indicates functional reversibility. The spectrum of FDG uptake levels in relation to Sestamibi uptake and dobutamine contraction reserve in areas with impaired function subtended by an occluded coronary artery has never been reported. Seventeen patients with stable angina pectoris and dysfunctional myocardium subtended by an occluded coronary artery were studied with FDG-PET, low-dose dobutamine echocardiography and Sestamibi-Single Photon Emission Computerized Tomography. In a 16 segment model dysfunctional myocardial segments showed a normally distributed FDG uptake ranging from 34% to 150% when normalized to peak segmental Sestamibi uptake. Low FDG uptake was associated with both lack of dobutamine induced contractile reserve and low Sestamibi uptake (in 73% of the segments) whereas high FDG uptake displayed both contractile reserve and Sestamibi uptake (57%). Segments with intermediate FDG uptake had either contractile reserve or a preserved Sestamibi uptake (62%). Dysfunctional myocardium subtended by an occluded coronary artery represents a continuum of metabolic states with a high degree of heterogeneity with regard to contractile reserve and Sestamibi uptake.