[Positron emission tomography (PET): a useful tool for the assessment of cardiac metabolism].

Under normal conditions, myocardial metabolism is based on the oxidation of fatty acids and in a lesser extent carbohydrates. Cardiac function depends upon an adequate supplement of adenosine triphosphate (ATP) by these substrates. However, the main source of energy is susceptible to change upon a various physiologic (exercise) as well as pathologic (ischemia-reperfusion) conditions. Recently, carnitine has gained attention as a modulator of fatty acids and carbohydrates metabolism by means of modifying intramitochondrial Acetyl-CoA/CoA ratio. Disturbances in fatty acids and carbohydrates metabolism in the myocardium have been associated with cardiovascular diseases (chronic ischemic disease, ventricular hypertrophy and dilated cardiomyopathy). The evaluation of cardiac metabolism attains great value regarding diagnosis, treatment and prognosis of these diseases. Currently, positron emission tomography (PET) is one of the preferred methods to evaluate cardiac energy metabolism in clinical practice. In PET images the tracers most commonly used are 11C-palmitate, 11C-acetate y 18Fluoro-2-deoxyglucose (FDG), the first two are employed to assess fatty acids oxidation and FDG is used to evaluate carbohydrates metabolism.