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Impaired myocardial microcirculation in the flow-glucose metabolism mismatch regions in revascularized acute myocardial infarction

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

In successfully revascularized acute myocardial infarction (AMI), microvascular function in a myocardial flow-glucose metabolism mismatch pattern has not been reported. We aimed to elucidate myocardial flow reserve (MFR) and myocardial viability in mismatch segments.

Methods

18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and adenosine stress 13N-ammonia PET were performed in eighteen AMI patients to evaluate myocardial glucose metabolism, myocardial blood flow (MBF), and MFR. Infarct segments were classified into 3 groups: normal (preserved resting MBF), mismatch (preserved FDG uptake but reduced resting MBF), and match (reduced FDG uptake and resting MBF). Regional wall motion score (WMS) was assessed immediately after reperfusion and recovery periods.

Results

MFR in the mismatch group was significantly lower than that in non-infarct-related segments (1.655 ± 0.516 vs 2.282 ± 0.629, P < .01) and similar to that in the match group (1.635 ± 0.528, P = .999). WMS in the mismatch group was significantly improved (3.07 ± 0.48 vs 2.07 ± 1.14, P = .003); however, in recovery periods, WMS in the mismatch group was significantly higher than that in the normal group (1.05 ± 1.04, P < .01).

Conclusions

In successfully revascularized AMI, microvascular function is impaired despite preserved myocardial glucose metabolism in mismatch segments.

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Abbreviations

AMI:

Acute myocardial infarction

MBF:

Myocardial blood flow

MFR:

Myocardial flow reserve

ATP:

Adenosine triphosphate

LVG:

Left ventriculography

WMS:

Wall motion score

NIRS:

Non-infarct-related segments

FDG:

Fluorodeoxyglucose

PET:

Positron emission tomography

MBq:

Megabecquerel

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Disclosure

The authors declare no conflict of interest associated with this manuscript.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan

    Yoshitomo Fukuoka MD, PhD, Akira Nakano MD, PhD, Naoto Tama MD, Kanae Hasegawa MD, PhD, Hiroyuki Ikeda MD, PhD, Tetsuji Morishita MD, PhD, Kentaro Ishida MD, PhD, Kenichi Kaseno MD, PhD, Naoki Amaya MD, PhD, Hiroyasu Uzui MD, PhD & Hiroshi Tada MD, PhD

  2. Division of Cardiology, Hikone Municipal Hospital, 1882 Hassakacho, Hikone, Shiga, 522-0057, Japan

    Akira Nakano MD, PhD

  3. Biomedical Imaging Research Center, Division of Medical Imaging, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan

    Hidehiko Okazawa MD, PhD

Authors
  1. Yoshitomo Fukuoka MD, PhD
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  2. Akira Nakano MD, PhD
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  3. Naoto Tama MD
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  4. Kanae Hasegawa MD, PhD
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  5. Hiroyuki Ikeda MD, PhD
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  6. Tetsuji Morishita MD, PhD
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  7. Kentaro Ishida MD, PhD
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  8. Kenichi Kaseno MD, PhD
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  9. Naoki Amaya MD, PhD
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  10. Hiroyasu Uzui MD, PhD
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  11. Hidehiko Okazawa MD, PhD
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  12. Hiroshi Tada MD, PhD
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Corresponding author

Correspondence to Hiroyasu Uzui MD, PhD.

Additional information

See related editorial, doi:10.1007/s12350-016-0575-3.

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Fukuoka, Y., Nakano, A., Tama, N. et al. Impaired myocardial microcirculation in the flow-glucose metabolism mismatch regions in revascularized acute myocardial infarction. J. Nucl. Cardiol. 24, 1641–1650 (2017). https://doi.org/10.1007/s12350-016-0526-z

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  • DOI: https://doi.org/10.1007/s12350-016-0526-z

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