A Reverse Flow-Metabolism Mismatch Pattern : A New Marker of Viable Myocardium With Greater Contractility During Dobutamine Stress Than Myocardium With a Flow-Metabolism Mismatch Pattern

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Few studies have investigated the contractility of myocardium with a reverse flow-metabolism pattern; that is, greater uptake of nitrogen-13-ammonia (NH_3) than fluorine-18-fluorodeoxyglucose (FDG) on positron emission tomography (PET). This study examined the contraction thickening represented by count increase in ECG-gated FDG-PET of myocardium with a reverse flow-metabolism pattern during low-dose dobutamine stress. Fifty-four patients with myocardial infarction were studied. Relative NH_3 and FDG uptake (%NH_3, %FDG) and %count increase were measured in 216 apical and 216 lateral segments on ECG-gated FDG-PET. The %count increase during low-dose dobutamine stress was greater in myocardium with a reverse flow-metabolism mismatch pattern than in myocardium with a flow-metabolism mismatch pattern (35.9±25.7% vs 24.6±15.9%, p=0.0221 in apical segments, and 38.4±22.6% vs 27.6±18.4%, p=0.0040 in lateral segments) despite smaller %FDG. A reverse flow-metabolism mismatch pattern should be noted as a new marker of viable myocardium with greater contractility during dobutamine stress than myocardium with a flow-metabolism mismatch pattern.
社団法人日本循環器学会の論文
2000-08-20