Document Detail


Nitrate administration increases blood flow in dysfunctional but viable myocardium, leading to improved assessment of myocardial viability: A PET study.
MedLine Citation:
PMID:  16883010     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SPECT with 99mTc-labeled agents is better able to detect viability after nitrate administration. Nitrates induce vasodilation and may increase blood flow to severely hypoperfused but viable myocardium, thereby enhancing tracer delivery and improving the detection of viability. Quantitative data on the changes in blood flow are lacking in SPECT but can be provided by PET. The aim of the present study was to use PET to evaluate whether nitrate administration increases blood flow to chronically dysfunctional but viable myocardium. METHODS: 13N-Ammonia PET was used to quantitatively assess blood flow, and 18F-FDG PET was used as the gold standard to detect viable myocardium. Twenty-five patients with chronic ischemic left ventricular dysfunction underwent 13N-ammonia PET at rest and after nitrate administration. RESULTS: A significant increase in nitrate-enhanced blood flow was observed in viable segments (from 0.55 +/- 0.15 to 0.68 +/- 0.24 mL/min/g, P < 0.05). No statistically significant change in blood flow was observed in nonviable segments (0.60 +/- 0.20 vs. 0.55 +/- 0.18 mL/min/g). A ratio of at least 1.1 for nitrate-enhanced flow to resting flow allowed optimal detection of viable myocardium, yielding a sensitivity of 82% with a specificity of 100%. CONCLUSION: 13N-Ammonia PET showed a significant increase in nitrate-enhanced blood flow in viable myocardium, whereas blood flow remained unchanged after nitrate administration in nonviable myocardium. Nitrate use during myocardial perfusion imaging will lead to improved assessment of myocardial viability.
Authors:
Riemer H J A Slart; Ali Agool; Dirk J van Veldhuisen; Rudi A Dierckx; Jeroen J Bax
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  47     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-02     Completed Date:  2006-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1307-11     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine and Molecular Imaging, University Medical Center, Groningen, The Netherlands. r.h.j.a.slart@nucl.umcg.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Male
Middle Aged
Myocardium / pathology*
Nitrates / chemistry,  pharmacology*
Perfusion
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use
Technetium / diagnostic use
Tomography, Emission-Computed, Single-Photon / methods*
Vasodilator Agents / pharmacology
Ventricular Dysfunction, Left / diagnosis
Chemical
Reg. No./Substance:
0/Nitrates; 0/Radiopharmaceuticals; 0/Vasodilator Agents; 63503-12-8/Fluorodeoxyglucose F18; 7440-26-8/Technetium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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