Dobutamine-stress electrocardiographically gated positron emission tomography for detection of viable but dysfunctional myocardium

• Published in: Journal of nuclear cardiology 1999-11, Vol.6 (6), p.626-632
• Main Authors: Yamagishi, Hiroyuki, Akioka, Kaname, Hirata, Kumiko, Sakanoue, Yuji, Toda, Iku, Yoshiyama, Minoru, Teragaki, Masakazu, Takeuchi, Kazuhide, Yoshikawa, Junichi, Ochi, Hironobu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Dobutamine; Echocardiography; Electrocardiography; Feasibility Studies; Female; fluorine-18 fluorodeoxyglucose; Fluorodeoxyglucose F18 - pharmacokinetics; Heart - diagnostic imaging; Heart - physiopathology; Heart attacks; Heart Rate - physiology; Humans; Male; Middle Aged; Myocardial Contraction - physiology; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - metabolism; Myocardial Infarction - physiopathology; Myocardium - metabolism; Myocardium - pathology; positron emission tomography; Radiopharmaceuticals - pharmacokinetics; Tissue Survival; Tomography; Tomography, Emission-Computed; Vasodilator Agents; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - metabolism; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - physiology
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1016/S1071-3581(99)90100-9

Purpose. This study was performed to determine whether low-dose dobutamine stress electrocardiography (ECG)-gated fluorine-18 fluorodeoxyglucose (FDG)—positron emission tomography (PET) can assess wall motion and identify myocardium without contractile reserve despite preserved FDG uptake. Methods. Fifty-three patients with myocardial infarction and normal sinus rhythm underwent ECG-gated FDG-PET and transthoracie echocardiography. Wall motion of 10 segments of the left ventricle was graded as normal, hypokinetic, or akinetic/dyskinetic. Results. In 365 (76%) of 480 segments, assessment of wall motion was concordant between the 2 modalities. In 30 patients dobutamine-stress ECG-gated FDG-PET was performed. In 13 (50%) of 26 dysfunctional segments with normal FDG uptake, 16 (36%) of 44 dysfunctional segments with mildly reduced FDG uptake and 12 (25%) of 48 dysfunctional segments with moderately reduced FDG uptake, wall motion was improved by dobutamine infusion. Conclusion. Assessment of left ventricular wall motion with ECG-gated FDG-PET is feasible, and dobutamine stress ECG-gated FDG-PET can simultaneously identify metabolic viability and contractile reserve.