TY - JOUR
T1 - Clinical significance of reduced regional myocardial glucose uptake in regions with normal blood flow in patients with chronic coronary artery disease
AU - Perrone-Filardi, Pasquale
AU - Bacharach, Stephen L.
AU - Dilsizian, Vasken
AU - Marin-Neto, JoséA
AU - Maurea, Simone
AU - Arrighi, James A.
AU - Bonow, Robert O.
N1 - Funding Information:
From the Cardiology Branch, National Heart, Lung, and Blood Institute and the Department of Nuclear Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland . Manuscript received May 13, 1992 ; revised manuscript received October 4, 1993, accepted October 14, 1993 . *Present address : Dr. Pasquale Perrone-Filardi, Cattedra di Cardiologia, University di Napoli "Federico II," Via S. Pansini 5,1-80131 Napoli, Italy. Address for correspondence: Dr. Robert 0. Bonow, Division of Cardiology, Northwestern University Medical School, Wesley Pavilion, Suite 524, 250 East Superior Street, Chicago, Illinois 60611 .
PY - 1994/3/1
Y1 - 1994/3/1
N2 - Objectives. The objective of this study was to assess the clinical significance of reduced regional fluorine-18 (18F) fluorodeoxyglucose uptake with normal flow in patients with chronic coronary artery disease. Background. In patients with ischemic left ventricular dysfunction, 18F-fluorodeoxyglucose uptake may be reduced in some myocardial regions despite normal flow. The significance of this finding to unclear and has not been investigated systematically. Methods. Twenty-three patients with coronary artery disease and impaired ventricular function (mean ejection fraction (±1 SD) 28 ± 10%) underwent positron emission tomography with 18F-fluorodeoxyglucose and oxygen-15-labeled water at rest, exercise thallium-201 tomographic imaging with rest reinjection and gated magnetic resonance imaging to measure end-diastolic wall thickness and systolisc wall thickening. Results. Of 168 regions with normal flow (≥0.7 ml/g per min), 125 (74%) had normal 18F-fluorodeoxyglucose uptake (98 ± 10%), and the remaining 43 (26%) showed moderately reduced 18F-fluorodeoxyglucose uptake (69 ± 8%). Systolic wall thickening was absent at rest in 14% of regions with normal 18F-fluorodeoxyglucose uptake compared with 32% of regions with reduced 18F-fluorodeoxyglucose uptake (p < 0.01). Reversible thallium abnormalities were observed in 45 (36%) of 125 regions with normal 18F-fluorodeoxyglucose uptake compared with 27 (63%) of 43 regions with reduced 18F-fluorodeoxyglucose uptake (p < 0.01). This difference was accounted for by a higher proportion of partially reversible defects in regions with reduced 18F-fluorodeoxyglucose uptake compared with regions with normal 18F-fluorodeoxyglucose uptake (42% vs. 18%, respectively, p < 0.01). Conclusions. Thus, regions with moderately reduced 18F-fluorodeoxyglucose uptake with normal flow occur commonly in patients with ischemic left ventricular dysfunction. The majority of these regions show impaired systolic function at rest and exercise-induced thallium abnormalities that are only partially reversible. These observations suggest that such regions represent an admixture of fibrotic and reversibly ischemic myocardium.
AB - Objectives. The objective of this study was to assess the clinical significance of reduced regional fluorine-18 (18F) fluorodeoxyglucose uptake with normal flow in patients with chronic coronary artery disease. Background. In patients with ischemic left ventricular dysfunction, 18F-fluorodeoxyglucose uptake may be reduced in some myocardial regions despite normal flow. The significance of this finding to unclear and has not been investigated systematically. Methods. Twenty-three patients with coronary artery disease and impaired ventricular function (mean ejection fraction (±1 SD) 28 ± 10%) underwent positron emission tomography with 18F-fluorodeoxyglucose and oxygen-15-labeled water at rest, exercise thallium-201 tomographic imaging with rest reinjection and gated magnetic resonance imaging to measure end-diastolic wall thickness and systolisc wall thickening. Results. Of 168 regions with normal flow (≥0.7 ml/g per min), 125 (74%) had normal 18F-fluorodeoxyglucose uptake (98 ± 10%), and the remaining 43 (26%) showed moderately reduced 18F-fluorodeoxyglucose uptake (69 ± 8%). Systolic wall thickening was absent at rest in 14% of regions with normal 18F-fluorodeoxyglucose uptake compared with 32% of regions with reduced 18F-fluorodeoxyglucose uptake (p < 0.01). Reversible thallium abnormalities were observed in 45 (36%) of 125 regions with normal 18F-fluorodeoxyglucose uptake compared with 27 (63%) of 43 regions with reduced 18F-fluorodeoxyglucose uptake (p < 0.01). This difference was accounted for by a higher proportion of partially reversible defects in regions with reduced 18F-fluorodeoxyglucose uptake compared with regions with normal 18F-fluorodeoxyglucose uptake (42% vs. 18%, respectively, p < 0.01). Conclusions. Thus, regions with moderately reduced 18F-fluorodeoxyglucose uptake with normal flow occur commonly in patients with ischemic left ventricular dysfunction. The majority of these regions show impaired systolic function at rest and exercise-induced thallium abnormalities that are only partially reversible. These observations suggest that such regions represent an admixture of fibrotic and reversibly ischemic myocardium.
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U2 - 10.1016/0735-1097(94)90744-7
DO - 10.1016/0735-1097(94)90744-7
M3 - Article
C2 - 8113542
AN - SCOPUS:0028295901
SN - 0735-1097
VL - 23
SP - 608
EP - 616
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 3
ER -