Document Detail


Myocardial 18F-FDG uptake after exercise-induced myocardial ischemia in patients with coronary artery disease.
MedLine Citation:
PMID:  18997035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have recently demonstrated the potential of (18)F-FDG as an imaging marker of myocardial ischemia if injected at peak exercise. However, how long increased (18)F-FDG uptake can be observed after an episode of exercise-induced myocardial ischemia is not known. We performed the current study to determine whether increased regional myocardial (18)F-FDG uptake at exercise in patients with coronary artery disease (CAD) persists on rest imaging (24 h later), after an episode of exercise-induced myocardial ischemia. METHODS: Twenty-four patients with suspected CAD underwent exercise (99m)Tc-sestamibi and (18)F-FDG imaging. Repeated (18)F-FDG imaging was performed 24 h after exercise imaging, after an injection of a second dose of (18)F-FDG at rest in 20 patients. Perfusion imaging with (99m)Tc-sestamibi was simultaneously performed with (18)F-FDG imaging. All patients underwent coronary angiography. RESULTS: Eighteen patients had greater than or equal to 70% luminal narrowing of 1 or more coronary vessels. Fifteen patients (83%) showed increased regional (18)F-FDG uptake on exercise imaging, but only 11 patients (61%) had perfusion abnormalities. Of these 15 patients with increased regional (18)F-FDG uptake on exercise imaging, 8 (53%) had no discernible (18)F-FDG uptake, 5 (33%) had decreased (18)F-FDG uptake, and only 2 (13%) had persistent (18)F-FDG uptake on rest (18)F-FDG images. The summed (18)F-FDG uptake score significantly decreased, from 14.4 +/- 10.3 at exercise to 6.7 +/- 9.2 at rest (P = 0.01). Patients with persistent (18)F-FDG uptake at rest had more (18)F-FDG uptake and lower peak rate-pressure product at exercise, compared with patients with no residual (18)F-FDG uptake at rest. CONCLUSION: Exercise-induced regional myocardial (18)F-FDG uptake is highly specific and sensitive for exercise-induced myocardial ischemia. Regional myocardial (18)F-FDG uptake may persist 24 h after an episode of exercise-induced myocardial ischemia in some patients.
Authors:
Ke-Fei Dou; Min-Fu Yang; Yue-Jin Yang; Diwakar Jain; Zuo-Xiang He
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-07
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  49     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-28     Completed Date:  2009-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1986-91     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Disease / etiology,  metabolism*,  radionuclide imaging*
Exercise Test
Female
Fluorodeoxyglucose F18 / diagnostic use*,  pharmacokinetics*
Humans
Male
Metabolic Clearance Rate
Middle Aged
Myocardial Ischemia / etiology,  metabolism*,  radionuclide imaging*
Positron-Emission Tomography / methods
Radiopharmaceuticals / diagnostic use,  pharmacokinetics
Reproducibility of Results
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections
Comment In:
J Nucl Med. 2008 Dec;49(12):1909-11   [PMID:  18997055 ]

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