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 -

Hiroyuki Yamagishi; Kaname Akioka; Kumiko Hirata; Yuji Sakanoue; Iku Toda; Minoru Yoshiyama; Masakazu Teragaki; Kazuhide Takeuchi; Junichi Yoshikawa; Hironobu Ochi

doi:10.1253/jcj.64.659

Clinical Studies

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 -

Hiroyuki Yamagishi, Kaname Akioka, Kumiko Hirata, Yuji Sakanoue, Iku Toda, Minoru Yoshiyama, Masakazu Teragaki, Kazuhide Takeuchi, Junichi Yoshikawa, Hironobu Ochi

Author information

Hiroyuki Yamagishi
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Kaname Akioka
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Kumiko Hirata
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Yuji Sakanoue
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Iku Toda
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Minoru Yoshiyama
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Masakazu Teragaki
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Kazuhide Takeuchi
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Junichi Yoshikawa
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan
Hironobu Ochi
Division of Nuclear Medicine, Osaka City University Medical School, Osaka, Japan

Keywords: Metabolism, Myocardial flow, Positron emission tomography

JOURNAL FREE ACCESS

2000 Volume 64 Issue 9 Pages 659-666

DOI https://doi.org/10.1253/jcj.64.659

Details

Abstract

Few studies have investigated the contractility of myocardium with a reverse flow--metabolism pattern; that is, greater uptake of nitrogen-13-ammonia (NH₃) 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 NH₃ and FDG uptake (%NH₃, %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.

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