TY - JOUR
T1 - Regional abnormality of oxygen consumption in reperfused myocardium assessed with [1-11C] acetate and positron emission tomography
AU - Buxton, D. B.
AU - Schwaiger, M.
AU - Mody, F. V.
AU - Krivokapich, J.
AU - Nienaber, C.
AU - Armbrecht, J.
AU - Luxen, A.
AU - Ratib, O.
AU - Phelps, M. E.
AU - Schelbert, H. R.
PY - 1989
Y1 - 1989
N2 - Previous studies with positron emission tomography (PET) have demonstrated prolonged abnormalities in myocardial glucose and fatty acid metabolism following transient occlusion of a coronary artery. The recent introduction of [1-11C] acetate as a tracer of overall oxidative metabolism provides a means for the in vivo assessment of regional myocardial oxygen consumption non-invasively. In this study, myocardial oxidative metabolism has been assessed in 11 closed-chest dogs 2 hours and 24 hours after a 20-minute balloon occlusion of the left anterior descending coronary artery. Myocardial glucose metabolism was assessed with [2-18F] fluorodeoxyglucose and PET, and regional function with two-dimensional echocardiography. [1-11C] acetate was administered intravenously, and regional clearance of 11C activity determined by dynamic PET. The rate constant for clearance of 11C activity from reperfused myocardium was 69 ± 15% (P < .001) of the clearance rate in normal myocardium 2 hours postreperfusion, indicating decreased oxygen consumption in reperfused sectors. Twenty-four hours post-reperfusion, 11C clearance in reperfused sectors had returned toward normal, being 90 ± 17% (not significant) of control sectors. Three hours postreperfusion, glucose metabolism was normal in reperfused sectors relative to control sectors; 24 hours postreperfusion, considerable variability was observed in glucose metabolism in reperfused sectors. In three dogs showing increased glucose metabolism in reperfused sectors relative to control sectors, oxidative metabolism was significantly inhibited in the reperfused sectors relative to seven dogs in which glucose metabolism was normal. This finding suggests use of anaerobic metabolism to compensate for inhibited aerobic metabolism in reperfused myocardium. It is concluded that the noninvasive measurement of regional oxidative metabolism with [1-11C] acetate and positron emission tomography allows the demonstration of decreased oxygen consumption in reversibly injured myocardium. Further, this technique is of potential value for following the clinical course of recovery of reperfused myocardium, and for assessing the degree of inhibition of oxidative metabolism in supply-limited states and the effects of therapeutic interventions on myocardial recovery.
AB - Previous studies with positron emission tomography (PET) have demonstrated prolonged abnormalities in myocardial glucose and fatty acid metabolism following transient occlusion of a coronary artery. The recent introduction of [1-11C] acetate as a tracer of overall oxidative metabolism provides a means for the in vivo assessment of regional myocardial oxygen consumption non-invasively. In this study, myocardial oxidative metabolism has been assessed in 11 closed-chest dogs 2 hours and 24 hours after a 20-minute balloon occlusion of the left anterior descending coronary artery. Myocardial glucose metabolism was assessed with [2-18F] fluorodeoxyglucose and PET, and regional function with two-dimensional echocardiography. [1-11C] acetate was administered intravenously, and regional clearance of 11C activity determined by dynamic PET. The rate constant for clearance of 11C activity from reperfused myocardium was 69 ± 15% (P < .001) of the clearance rate in normal myocardium 2 hours postreperfusion, indicating decreased oxygen consumption in reperfused sectors. Twenty-four hours post-reperfusion, 11C clearance in reperfused sectors had returned toward normal, being 90 ± 17% (not significant) of control sectors. Three hours postreperfusion, glucose metabolism was normal in reperfused sectors relative to control sectors; 24 hours postreperfusion, considerable variability was observed in glucose metabolism in reperfused sectors. In three dogs showing increased glucose metabolism in reperfused sectors relative to control sectors, oxidative metabolism was significantly inhibited in the reperfused sectors relative to seven dogs in which glucose metabolism was normal. This finding suggests use of anaerobic metabolism to compensate for inhibited aerobic metabolism in reperfused myocardium. It is concluded that the noninvasive measurement of regional oxidative metabolism with [1-11C] acetate and positron emission tomography allows the demonstration of decreased oxygen consumption in reversibly injured myocardium. Further, this technique is of potential value for following the clinical course of recovery of reperfused myocardium, and for assessing the degree of inhibition of oxidative metabolism in supply-limited states and the effects of therapeutic interventions on myocardial recovery.
UR - http://www.scopus.com/inward/record.url?scp=0024834451&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:0024834451
SN - 0887-7971
VL - 3
SP - 276
EP - 287
JO - American Journal of Cardiac Imaging
JF - American Journal of Cardiac Imaging
IS - 4
ER -