Abstract
Cardiac metabolism refers to a complex system of interconnected chemical reactions. In broad terms, metabolism provides the energy for contraction and the materials for the heart’s structure and function. A defining feature of metabolism is the flux of chemical compounds that can be traced by physical methods, including radioactive decay of tracers or magnetic resonance spectroscopy. Metabolic activity is a dynamic process found only in living cells and tissues. In addition to the dynamic nature of metabolic activity, intermediary metabolites also control cell function, either as regulators of enzyme activity or as posttranslational modifiers of protein function and transcriptional activity. An important recent development in the field of nuclear cardiology is the concept that metabolic remodeling of the heart precedes, triggers, and sustains structural and functional remodeling, and that metabolism is inextricably linked to both physiology and molecular biology of the heart. This concept offers unprecedented opportunities for metabolic imaging.
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References
Taegtmeyer H, Young ME, Lopaschuk GD, Abel ED, Brunengraber H, Darley-Usmar V, et al. American Heart Association Council on basic cardiovascular sciences. Assessing cardiac metabolism: a scientific statement from the American Heart Association. Circ Res. 2016;118:1659–701.
Kundu B, Zhong M, Sen S, Davogustto G, Keller S, Taegtmeyer H. Remodeling of glucose metabolism precedes pressure overload-induced left ventricular hypertrophy: review of a hypothesis. Cardiology. 2015;130:211–20.
Taegtmeyer H, Golfman L, Sharma S, Razeghi P, van Arsdall M. Linking gene expression to function: metabolic flexibility in the normal and diseased heart. Ann N Y Acad Sci. 2004;1015:202–13.
Taegtmeyer H, Lam T, Davogustto G. Cardiac metabolism in perspective. Compr Physiol. 2016;6:1675–99.
Davogustto G, Taegtmeyer H. The changing landscape of cardiac metabolism. J Mol Cell Cardiol. 2015;84:129–32.
Taegtmeyer H, Hems R, Krebs HA. Utilization of energy-providing substrates in the isolated working rat heart. Biochem J. 1980;186:701–11.
Osterholt M, Sen S, Dilsizian V, Taegtmeyer H. Targeted metabolic imaging to improve the management of heart disease. JACC Cardiovasc Imaging. 2012;5:214–26.
Depre C, Young ME, Ying J, Ahuja HS, Han Q, Garza N, et al. Streptozotocin-induced changes in cardiac gene expression in the absence of severe contractile dysfunction. J Mol Cell Cardiol. 2000;32:985–96.
Goodwin GW, Taylor CS, Taegtmeyer H. Regulation of energy metabolism of the heart during acute increase in heart work. J Biol Chem. 1998;273:29530–9.
Nguyen VT, Mossberg KA, Tewson TJ, Wong WH, Rowe RW, Coleman GM, Taegtmeyer H. Temporal analysis of myocardial glucose metabolism by 2-[18F]fluoro-2-deoxy-D-glucose. Am J Phys. 1990;259:H1022–31.
Sharma S, Adrogue JV, Golfman L, Uray I, Lemm J, Youker K, et al. Intramyocardial lipid accumulation in the failing human heart resembles the lipotoxic rat heart. FASEB J. 2004;18:1692–700.
Taegtmeyer H, McNulty P, Young ME. Adaptation and maladaptation of the heart in diabetes: part I: general concepts. Circulation. 2002;105:1727–33.
Depre C, Shipley GL, Chen W, Han Q, Doenst T, Moore ML, et al. Unloaded heart in vivo replicates fetal gene expression of cardiac hypertrophy. Nat Med. 1998;4:1269–75.
Dewald O, Sharma S, Adrogue J, Salazar R, Duerr GD, Crapo JD, et al. Downregulation of peroxisome proliferator-activated receptor-alpha gene expression in a mouse model of ischemic cardiomyopathy is dependent on reactive oxygen species and prevents lipotoxicity. Circulation. 2005;112:407–15.
Feinendegen LE. Myocardial imaging of lipid metabolism with labeled fatty acids. In: Dilsizian V, editor. Myocardial viability: a clinical and scientific treatise. Armonk: Futura; 2000. p. 349–89.
Messina SA, Aras O, Dilsizian V. Delayed recovery of fatty acid metabolism after transient myocardial ischemia: a potential imaging target for “ischemic memory”. Curr Cardiol Rep. 2007;9:159–65.
Gropler RJ, Siegel BA, Sampathkumaran K, Pérez JE, Sobel BE, Bergmann SR, Geltman EM. Dependence of recovery of contractile function on maintenance of oxidative metabolism after myocardial infarction. J Am Coll Cardiol. 1992;19:989–97.
Gropler RJ, Geltman EM, Sampathkumaran K, Pérez JE, Moerlein SM, Sobel BE, et al. Functional recovery after coronary revascularization for chronic coronary artery disease is dependent on maintenance of oxidative metabolism. J Am Coll Cardiol. 1992;20:569–77.
Schelbert HR. Principles of positron emission tomography. In: Skorton DJ, Schelbert HR, Wolf GL, Brundage BH, editors. Marcus cardiac imaging: a companion to Braunwald’s heart disease. 2nd ed. Philadelphia: WB Saunders; 1996. p. 1063–92.
Dilsizian V, Bacharach SL, Beanlands SR, Bergmann SR, Delbeke D, Fischman AJ, et al. ASNC imaging guidelines for nuclear cardiology procedures: PET myocardial perfusion and metabolism clinical imaging. J Nucl Cardiol. 2009;16:651. https://doi.org/10.1007/s12350-009-9094-9.
Dilsizian V. Perspectives on the study of human myocardium: viability. In: Dilsizian V, editor. Myocardial viability: a clinical and scientific treatise. Armonk: Futura; 2000. p. 3–22.
Tillisch J, Brunken R, Marshall R, Schwaiger M, Mandelkern M, Phelps M, Schelbert H. Reversibility of cardiac wall-motion abnormalities predicted by positron tomography. N Engl J Med. 1986;314:884–8.
Dilsizian V, Arrighi JA. Myocardial viability in chronic coronary artery disease: perfusion, metabolism and contractile reserve. In: Gerson MC, editor. Cardiac nuclear medicine. 3rd ed. New York: McGraw-Hill; 1996. p. 143–91.
Eitzman D, Al-aouar Z, Kanter HL, vom Dahl J, Kirsh M, Deeb GM, Schwaiger M. Clinical outcome of patients with advanced coronary artery disease after viability studies with positron emission tomography. J Am Coll Cardiol. 1992;20:559–65.
Di Carli MF, Davidson M, Little R, Khanna S, Mody FV, Brunken RC, et al. Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction. Am J Cardiol. 1994;73:527–33.
Di Carli MF, Asgarzadie F, Schelbert HR, Brunken RC, Laks H, Phelps ME, Maddahi J. Quantitative relation between myocardial viability and improvement in heart failure symptoms after revascularization in patients with ischemic cardiomyopathy. Circulation. 1995;92:3436–44.
Haas F, Haehnel CJ, Picker W, Nekolla S, Martinoff S, Meisner H, Schwaiger M. Preoperative positron emission tomography viability assessment and perioperative and postoperative risk in patients with advanced ischemic heart disease. J Am Coll Cardiol. 1997;30:1693–700.
Srinivasan G, Kitsiou AN, Bacharach SL, Bartlett ML, Miller-Davis C, Dilsizian V. 18F-fluorodeoxyglucose single photon emission computed tomography: can it replace PET and thallium SPECT for the assessment of myocardial viability? Circulation. 1998;97:843–50.
Dilsizian V. FDG uptake as a surrogate marker for antecedent ischemia. J Nucl Med. 2008;49:1909–11.
Camici P, Araujo LI, Spinks T, Lammertsma AA, Kaski JC, Shea MJ, et al. Increased uptake of 18F-fluorodeoxyglucose in postischemic myocardium of patients with exercise-induced angina. Circulation. 1986;74:81–8.
He ZX, Shi RF, Wu YJ, Tian YQ, Liu XJ, Wang SW, et al. Direct imaging of exercise-induced myocardial ischemia with fluorine-18-labeled deoxyglucose and Tc-99m-sestamibi in coronary artery disease. Circulation. 2003;108:1208–13.
Dou KF, Yang MF, Yang YJ, Jain D, He ZX. Myocardial 18F-FDG uptake after exercise-induced myocardial ischemia in patients with coronary artery disease. J Nucl Med. 2008;49:1986–91.
Taegtmeyer H, Dilsizian V. Imaging myocardial metabolism and ischemic memory. Nat Clin Pract Cardiovasc Med. 2008;5:S42–8.
Dilsizian V, Bateman TM, Bergmann SR, Des Prez R, Magram MY, Goodbody AE, et al. Metabolic imaging with beta-methyl-para-[123I]-iodophenyl-pentadecanoic acid (BMIPP) identifies ischemic memory following demand ischemia. Circulation. 2005;112:2169–74.
Krebs H. The Pasteur effect and the relation between respiration and fermentation. Essays Biochem. 1972;8:1–34.
Di Carli MF, Prcevski P, Singh TP, Janisse J, Ager J, Muzik O, Vander HR. Myocardial blood flow, function, and metabolism in repetitive stunning. J Nucl Med. 2000;41:1227–34.
Dickfeld T, Lei P, Dilsizian V, Jeudy J, Dong J, Voudouris A, et al. Integration of three-dimensional scar maps for ventricular tachycardia ablation with positron emission tomography-computed tomography. JACC Cardiovasc Imaging. 2008;1:73–82.
United States Renal Data System. 2018 USRDS annual data report: Epidemiology of kidney disease in the United States. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2018.
Tyralla K, Amann K. Morphology of the heart and arteries in renal failure. Kidney Int. 2003;63:S80–3.
Nishimura M, Tsukamoto K, Hasebe N, Tamaki N, Kikuchi K, Ono T. Prediction of cardiac death in hemodialysis patients by myocardial fatty acid imaging. J Am Coll Cardiol. 2008;51:139–45.
Lodge MA. Evidence for inverse relationship between myocardial glucose utilization with PET and severity of renal dysfunction [abstract]. J Nucl Med. 2007;48(Suppl 2):108P.
Nishimura M, Hashimoto T, Kobayashi H, Fukuda T, Okino K, Yamamoto N, et al. Myocardial scintigraphy using a fatty acid analogue detects coronary artery disease in hemodialysis patients. Kidney Int. 2004;66:811–9.
Dilsizian V, Fink J. Deleterious effect of altered myocardial fatty acid metabolism in kidney disease. J Am Coll Cardiol. 2008;51:146–8.
Fink JC, Lodge MA, Smith MF, Hinduja A, Brown J, Dinits-Pensy MY, Dilsizian V. Pre-clinical myocardial metabolic alterations in chronic kidney disease. Cardiology. 2010;116:160–7.
Hofmann M, Wollert KC, Meyer GP, Menke A, Arseniev L, Hertenstein B, et al. Monitoring of bone marrow cell homing into the infarcted human myocardium. Circulation. 2005;111:2198–202.
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Taegtmeyer, H., Dilsizian, V. (2021). Imaging Cardiac Metabolism. In: Dilsizian, V., Narula, J. (eds) Atlas of Nuclear Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-49885-6_9
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