Early assessment of regional myocardial blood flow and metabolism in thrombolysis in myocardial infarction flow grade 3 reperfused myocardial infarction using carbon-11-acetate.

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  • Additional Information
    • Source:
      Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print Cited Medium: Print ISSN: 0735-1097 (Print) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983-
    • Subject Terms:
      Thrombolytic Therapy* ; Tomography, Emission-Computed*; Coronary Circulation/*physiology ; Energy Metabolism/*physiology ; Myocardial Infarction/*drug therapy ; Myocardial Reperfusion Injury/*diagnostic imaging; Acetates ; Adult ; Aged ; Carbon Radioisotopes ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction/diagnostic imaging ; Predictive Value of Tests ; Radionuclide Angiography
    • Abstract:
      Objectives: The aim of this study was to investigate the prognostic value of carbon-11-acetate (acetate) positron emission tomography (PET) after successful reperfusion of myocardial infarction (MI).
      Background: Acetate PET allows the measurement of both myocardial flow and oxidative metabolism. The prognostic value of acetate measurements performed early (within 24 h) after Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 reperfused MI is unknown.
      Methods: In 18 patients with TIMI flow grade 3 reperfusion of their first MI, a dynamic acetate study was performed within 24 h of the acute event. At five days, nitrogen-13-NH3 (NH3) and fluorine-18-labeled fluorodeoxyglucose (FDG) PET studies were performed. Infarct-related areas were classified as "PET viable" or "PET nonviable," as assessed with NH3 and FDG, according to previously established criteria. At five days and three months, radionuclide angiography was performed for evaluation of left ventricular (LV) function.
      Results: In infarct-related regions, myocardial blood flow, FDG uptake and oxygen consumption were decreased, compared with remote regions. However, oxygen consumption values, as measured with acetate in both PET-viable and PET-nonviable areas, as assessed with NH3 and FDG, were not significantly different (p = NS). A significant linear correlation was observed between global LV ejection fraction at three months and oxidative metabolism in the infarct-related area (r = 0.8, p < 0.0001). Multivariate analysis revealed that oxidative metabolism measurements in reperfused myocardium was the only significant predictor for recovery of LV function at three months (p < 0.05).
      Conclusions: Measurement of oxidative metabolism early after TIMI flow grade 3 reperfusion of MI offers important prognostic value concerning LV function at follow-up.
    • Accession Number:
      0 (Acetates)
      0 (Carbon Radioisotopes)
    • Publication Date:
      Date Created: 20010112 Date Completed: 20010125 Latest Revision: 20190708
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/s0735-1097(00)01088-3
    • Accession Number:
      11153755