Myocardial Energetics

Abstract

Successful imaging of any organ requires a basic knowledge of the physiology of the tissue involved. In considering the heart, it is important to realize that the myocardium is richly vascular at all times, both in the normal resting state and in the chronic postinfarction state. This is particularly true during acute myocardial infarction, when the inflammatory process envelops the area of ischemia, rendering the entire zone plethoric and even hemorrhagic. The changes that occur in the metabolic processes at the time of myocardial injury are important to the physician who wishes to tag these areas with radionuclides. The uptake of compounds is largely dependent on the integrity and nature of existing metabolic processes. It is therefore worthwhile to consider the changes that occur in the myocardium throughout the various stages from normal aerobic metabolism to total infarction and anaerobic metabolism.