Advertisement

Is it worth assessing regional myocardial viability with positron emission tomography?

  • Christian de Landsheere
  • Luc Piérard
  • Pierre Melon
  • Dominique Comar
  • Henri E. Kulbertus
  • Pierre Rigo
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 133)

Abstract

For many years, tracers of perfusion have been used for the diagnosis of regional myocardial ischemia. For this purpose, thallium-201 has been, by far, the most widely used tracer in single photon scintigraphy. However, thallium-201 scintigraphy — even in the tomographic mode (SPECT) — underestimates regional viability, particularly after myocardial infarction. Tamaki et al. [1,2].

Keywords

Positron Emission Tomography Glucose Uptake Myocardial Blood Flow Myocardial Viability Anterior Myocardial Infarction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Tamaki N, Ohtani H, Yonekura Y et al. Can reinjection of thallium-201 SPECT replace FDG-PET for assessing tissue viability [abstract]? J Nucl Med 1990; 31: 742.Google Scholar
  2. 2.
    Tamaki N, Ohtani H, Yamashita K et al. Metabolic activity in the areas of new fill-in after thallium-201 reinjection: comparison with positron emission tomography using fluorine-18-deoxyglucose. J Nucl Med 1991; 32: 673–8.PubMedGoogle Scholar
  3. 3.
    Randle PJ, Garland PB, Hales CN, Newsholme EA. The glucose-fatty acid cycle. Lancet 1963; i: 785–9.CrossRefGoogle Scholar
  4. 4.
    Neely JR, Morgan HE. Relationship between carbohydrate and lipid metabolism and the energy balance of the heart muscle. Annu Rev Physiol 1974; 36: 413–59.PubMedCrossRefGoogle Scholar
  5. 5.
    Opie LH. Effect of regional ischemia on metabolism of glucose and fatty acids. Circ Res 1976; 38 Suppl 1:153–174.Google Scholar
  6. 6.
    Liedtke AJ. Alterations of carbohydrate and lipid metabolism in the acutely ischemic heart. Progr Cardiovasc Dis 1981; 23: 321–6.CrossRefGoogle Scholar
  7. 7.
    Marshall RC, Tillisch JH, Phelps ME et al. Identification and differentiation of resting myocardial ischemia and infarction in man with positron computed tomography, F-18 labeled fluorodeoxyglucose and N13-ammonia. Circulation 1983; 67: 766–78.PubMedCrossRefGoogle Scholar
  8. 8.
    De Landsheere C, Raets D, Pierard L et al. Residual metabolic abnormalities and regional viability after a myocardial infarction: a study using positron tomography, F-18 deoxyglucose and flow indicators [abstract]. J Am Coll Cardiol 1985a; 5: 451.Google Scholar
  9. 9.
    De Landsheere CM, Raets D, Pierard LA et al. Fibrinolysis and viable myocardium after an acute infarction: a study of regional perfusion and glucose utilization with positron emission tomography [abstract]. Circulation 1985b; 72(4 Suppl III): III393.Google Scholar
  10. 10.
    De Landsheere C, Raets D, Pierard L et al. Thrombolysis in anterior myocardial infarction: effect on regional viability studied with positron emission tomography [abstract]. Circulation 1987a; 76(4 Suppl IV): IV5.Google Scholar
  11. 11.
    De Landsheere C, Raets D, Pierard L et al. Investigation of myocardial viability after an acute myocardial infarction using positron emission tomography. In Heiss WD, Pawlik G, Herholz K, Wienhard K, editors. Clinical efficacy of positron emission tomography, Dordrecht: Martinus Nijhoff, 1987b: 279–96.Google Scholar
  12. 12.
    De Landsheere C, Raets D, Pierard L et al. Viabilité myocardique après infarctus du myocarde traité par fibrinolyse: évaluation directe par tomographie à émission de positons combinant une étude régionale de la perfusion et de la captation glucidique. J Biophys Bioméc 1987c; 11(Suppl 2): 185–7.Google Scholar
  13. 13.
    De Landsheere CM. Assessment of glucose utilization in normal and ischemic myocardium with positron emission tomography and 18F-deoxyglucose. In: Van der Wall E, editor. Noninvasive imaging of cardiac metabolism, Dordrecht: Martinus Nijhoff, 1987d: 241–63.Google Scholar
  14. 14.
    De Landsheere C, Raets D, Pierard L et al. Regional myocardial perfusion and glucose uptake: clinical experience in 92 cases studied with positron tomography [abstract]. Eur J Nucl Med 1989; 15: 446.Google Scholar
  15. 15.
    De Landsheere C. Contribution de la tomographie par émission de positons à l’étude de l’insuffisance coronarienne. Thèse d’agrégation de l’enseignement supérieur, 1990 [dissertation].Google Scholar
  16. 16.
    Rigo P, De Landsheere C, Raets D, Del Fiore G, Quaglia L, Lemaire C. Myocardial blood flow and glucose uptake after myocardial infarction. Eur J Nucl Med 1986; 12: S59–S61.PubMedCrossRefGoogle Scholar
  17. 17.
    Pierard LA, De Landsheere C, Berthe C, Rigo P, Kulbertus HE. Identification of viable myocardium by echocardiography during dobutamine infusion in patients with myocardial infarction after thrombolytic therapy: comparison with positron emission tomography. J Am Coll Cardiol 1990; 15: 1021–31.PubMedCrossRefGoogle Scholar
  18. 18.
    Guttman I. Statistical tolerance regions. London: Griffin, 1970.Google Scholar
  19. 19.
    De Landsheere C, Pierard L, Melon P et al. Understanding perfusion and glucose uptake patterns by the use of low-dose dobutamine in 29 patients with anterior myocardial infarction. J Am Coll Cardiol 1992 [in press].Google Scholar
  20. 20.
    Grandin C, Melin JA, Essamri B et al. Prediction of functional improvement with PET in patients recovering from acute anterior ischemia [abstract]. J Nucl Med 1991; 32: 1012.Google Scholar
  21. 21.
    Schwaiger M, Hicks R. The clinical role of metabolic imaging of the heart by positron emission tomography. J Nucl Med 1991; 32: 565–78.PubMedGoogle Scholar
  22. 22.
    Schelbert HR. Assessment of myocardial viability with positron emission tomography. Proceedings of the third annual international PET conference of the Institute for Clinical PET. Washington D.C. 1991: 38–41.Google Scholar
  23. 23.
    Brunken R, Tillisch J, Schwaiger M et al. Regional perfusion, glucose metabolism, and wall motion in patients with chronic electrocardiographic Q wave infarctions: evidence for persistence of viable tissue in some infarct regions by positron emission tomography. Circulation 1986; 73: 951–63.PubMedCrossRefGoogle Scholar
  24. 24.
    Tillisch J, Brunken R, Marshall l.et al. Reversibility of cardiac wall-motion abnormalities predicted by positron tomography. N Engl J Med 1986; 314: 884–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Tamaki N, Yonekura Y, Yamashita K et al. Positron emission tomography using fluorine-18-deoxyglucose in evaluation of coronary artery bypass grafting. Am J Cardiol 1989; 64: 860–5.PubMedCrossRefGoogle Scholar
  26. 26.
    Al-Aouar ZR, Eitzman D, Hepner A et al. PET assessment of myocardial tissue viability. University of Michigan experience [abstract]. J Nucl Med 1990; 31: 801.Google Scholar
  27. 27.
    Brunken R, Schwaiger M, Grover-McKay M, Phelps ME, Tillisch J, Schelbert HR. Positron emission tomography detects tissue metabolic activity in myocardial segments with persistent thallium perfusion defects. J Am Coll Cardiol 1987; 10: 557–67.PubMedCrossRefGoogle Scholar
  28. 28.
    Brunken RC, Kottou S, Nienaber CA et al. PET detection of viable tissue in myocardial segments with persistent defects at Tl-201 SPECT Radiology 1989; 172: 65–73.Google Scholar
  29. 29.
    Tamaki N, Yonekura Y, Yamashita K et al. Relation of left ventricular perfusion and wall motion with metabolic activity in persistent defects on thallium-201 tomography in healed myocardial infarction. Am J Cardiol 1988; 62: 202–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Bonow R, Dilsizian V, Cuocolo A, Bacharach S. Identification of viable myocardium in patients with chronic artery disease and left ventricular dysfunction: comparison of thallium scintigraphy with reinjection and PET imaging with 18F-fluorodeoxyglucose. Circulation 1991; 83: 26–37.PubMedCrossRefGoogle Scholar
  31. 31.
    Eitzman D, Al-Azouar Z, Kanter L et al. Clinical outcome in patients with advanced coronary artery disease following PET viability studies [abstract]. J Nucl Med 1991; 32: 1011–2.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1992

Authors and Affiliations

  • Christian de Landsheere
  • Luc Piérard
  • Pierre Melon
  • Dominique Comar
  • Henri E. Kulbertus
  • Pierre Rigo

There are no affiliations available

Personalised recommendations