Abstract
The techniques currently used to assess myocardial infarction are limited in their ability to determine the amount of viable myocardium after a temporary ischemic event. Blood flow and segmental function may not necessarily demonstrate salvage, whereas metabolic parameters will determine cell survival. In an open chest dog model, short occlusion times of 20 min and subsequent reperfusion using C-11 palmitate as an index of fatty acid metabolism showed depression of fatty acid oxidation, which recovered after 3 hours of reperfusion, indicating the partial reversibility of the ischemic condition. In more extensive studies, using positron emission tomography (PET) and, as an indicator of glucose metabolism, fluoro-F-18-deoxyglucose (FDG); N-13 ammonia in addition to C-11 palmitate for the determination of blood flow; and ultrasonic crystals to measure shortening in the reperfused and control territories, the duration of occlusion was 3 h. Metabolic studies were repeated 24 h, 1 week, and 4 weeks after the ischemic injury. Reperfused viable myocardium exhibited residual glucose metabolism with FDG, whereas fatty acid oxidation remained impaired for a longer period. Gradual metabolic recovery during a 4-week period was associated with the prolonged recovery of regional function, whereas a lack of residual metabolic activity indicated that little change in function was likely to occur. Increased FDG uptake and impaired C-11 palmitate turnover are characteristic of reversibly injured tissue. Therefore, PET studies may offer a unique potential for the evaluation of therapeutic measures such as thrombolysis and early revascularization.
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Operated for the US Department of Energy by the University of California under contract no. DE-AC03-76-SF00012. This work was supported in part by the Director of the Office of Energy Research, Office of Health and Environmental Research, by NIH grant nos. HL 29845 and HL 33177, and by an Investigatorship Group Award by the Greater Los Angeles Affiliate of the American Heart Association
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Schwaiger, M. Time course of metabolic findings in coronary occlusion and reperfusion and their role for assessing myocardial salvage. Eur J Nucl Med 12 (Suppl 1), S54–S58 (1986). https://doi.org/10.1007/BF00258107
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DOI: https://doi.org/10.1007/BF00258107