Silent myocardial ischemia in patients with myocardial infarction: evaluation with positron emission computed tomography

• Published in: Japanese circulation journal Vol. 53; no. 11; pp. 1437 - 1443
• Main Authors: KAMBARA, H, FUDO, T, HASHIMOTO, T, HAYASHI, M, KAWAI, C, TAMAKI, N, YAMASHITA, K, YONEKURA, Y, KONISHI, J
• Format: Journal Article
• Language: English
• Published: Kyoto Japanese Circulation Society 01.11.1989
• Subjects: Adult; Aged; Ammonia; Angina Pectoris - diagnostic imaging; Angina Pectoris - etiology; Angina Pectoris - physiopathology; Biological and medical sciences; Cardiology. Vascular system; Coronary Circulation; Coronary Disease - diagnostic imaging; Coronary Disease - etiology; Coronary Disease - physiopathology; Coronary heart disease; Deoxyglucose - analogs & derivatives; Deoxyglucose - pharmacokinetics; Exercise Test; Fluorine Radioisotopes - pharmacokinetics; Fluorodeoxyglucose F18; Glucose - metabolism; Heart; Heart - diagnostic imaging; Humans; Medical sciences; Middle Aged; Myocardial Infarction - complications; Myocardium - metabolism; Nitrogen Radioisotopes; Tomography, Emission-Computed; Human; Infarct; Cardiovascular disease; Exploration; Asymptomatic; Glucose; Metabolism; Coronary heart disease; Blood flow; Ischemia; Myocardium; Hemodynamics; Technique; Positron emission tomography
• ISSN: 0047-1828; 1347-4839
• DOI: 10.1253/jcj.53.1437

To evaluate myocardial blood flow and glucose utilization, N-13 ammonia and F-18 deoxyglucose positron emission tomography were performed in 33 patients with myocardial infarction. The N-13 ammonia study was performed at rest and during supine exercise, and the F-18 deoxyglucose was done at rest after greater than or equal to 5 hours of fasting. Based on angina, exercise-induced hypoperfusion, and deoxyglucose uptake, 3 groups of patients were classified; 10 patients in group I (neither angina nor exercise induced hypoperfusion), 8 patients in group II (painless exercise-induced hypoperfusion) and 15 patients in group III (anginal patients with/without exercise-induced hypoperfusion). The F-18 deoxyglucose positron study demonstrated accumulation of deoxyglucose in 6 patients in group I, 7 in group II, and 14 in group III. Thus, our results indicated that a significant number of patients with antecedent myocardial infarction had exercise-induced hypoperfusion and/or altered glucose metabolism without accompanying anginal pain.