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Clinical significance of quantitative assessment of glucose utilization in patients with ischemic cardiomyopathy

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The aim of this study was to prospectively quantify the rate of myocardial glucose uptake (MRGlu) in myocardium with different perfusion-metabolism patterns and determine its prognostic value in patients with ischemic cardiomyopathy.

Methods and Results

79 patients with ischemic cardiomyopathy were prospectively enrolled for dynamic cardiac FDG PET, and then followed for at least 6 months. Perfusion-metabolism patterns were determined based on visual score analysis of 201Tl SPECT and FDG PET. MRGlu was analyzed using the Patlak kinetic model. The primary end-point was cardiovascular mortality. Significantly higher MRGlu was observed in viable compared with non-viable areas. Negative correlations were found between MRGlu in transmural match and a history of hyperlipidemia, statin usage, and triglyceride levels. Diabetic patients receiving dipeptidyl peptidase-4 inhibitors (DPP4i) had a significantly lower MRGlu in transmural match, mismatch, and reverse mismatch. Patients with MRGlu in transmural match ≥ 23.40 or reverse mismatch ≥ 36.90 had a worse outcome.

Conclusions

Myocardial glucose utilization was influenced by substrates and medications, including statins and DPP4i. MRGlu could discriminate between viable and non-viable myocardium, and MRGlu in transmural match and reverse mismatch may be prognostic predictors of cardiovascular death in patients with ischemic cardiomyopathy.

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Abbreviations

18F-FDG:

18F-fluorodeoxyglucose

PET:

Positron emission tomography

201Tl SPECT:

201Tl single photon emission computed tomography

ECG:

Electrocardiogram

LV:

Left ventricular

EF:

Ejection fraction

FA:

Fatty acid

HF:

Heart failure

CAD:

Coronary artery disease

CV:

Cardiovascular

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Acknowledgments

The authors thank Ms. Ya-Huang Chen, Ms. Chia-Wen Lai, Mr. Chao-Chun Huang and Mr. Po-Wei Li for dynamic PET acquisition, and Ms. Yu-Shuan Hung, Dr Szu-Ying Tsai, and Mr. Chien-Yu Chu for their assistance in PET analyses and clinical data collection.

Disclosure

All authors declare that they have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Nuclear Medicine, National Taiwan University Hospital, Yunlin Branch, Yunlin County, Taiwan

    Kuan-Yin Ko MD

  2. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Kuan-Yin Ko MD & Yen-Wen Wu MD, PhD

  3. Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan

    Shan-Ying Wang MD, Yu-Chien Shiau MD, PhD & Yen-Wen Wu MD, PhD

  4. Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Ruoh-Fang Yen MD, PhD

  5. National Taiwan University College of Medicine, Taipei, Taiwan

    Ruoh-Fang Yen MD, PhD

  6. Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan

    Jung-Cheng Hsu MD, Hao-Yuan Tsai MD, Chien-Lin Lee MD & Yen-Wen Wu MD, PhD

  7. Division of Cardiovascular Surgery, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan

    Kuan-Ming Chiu MD, PhD

  8. National Yang-Ming University School of Medicine, Taipei, Taiwan

    Yen-Wen Wu MD, PhD

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Correspondence to Yen-Wen Wu MD, PhD.

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Funding

This study was supported by the Ministry of Science and Technology of Taiwan (MOST 101-2314-B-418-012-MY3, 104-2314-B-418-008; 105-2628-B-418-002-MY2) and mutual found from Far Eastern Memorial Hospital (FEMH 101-2314-B-418-012-MY3, 104-2314-B-418-008; 105-2628-B-418-002-MY2).

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Ko, KY., Wang, SY., Yen, RF. et al. Clinical significance of quantitative assessment of glucose utilization in patients with ischemic cardiomyopathy. J. Nucl. Cardiol. 27, 269–279 (2020). https://doi.org/10.1007/s12350-018-1395-4

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  • DOI: https://doi.org/10.1007/s12350-018-1395-4

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