Ke-Fei Dou1, Min-Fu Yang, Yue-Jin Yang, Diwakar Jain, Zuo-Xiang He. 1. Department of Cardiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Abstract
UNLABELLED: 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.
UNLABELLED: 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: Robert J Gropler; Rob S B Beanlands; Vasken Dilsizian; E Douglas Lewandowski; Flordeliza S Villanueva; Maria Cecilia Ziadi Journal: J Nucl Med Date: 2010-05-01 Impact factor: 10.057
Authors: Richard M de Jong; Rene A Tio; Pim van der Harst; Adriaan A Voors; Paul M Koning; Clark J A M Zeebregts; Dirk J van Veldhuisen; Rudi A J O Dierckx; Riemer H J A Slart Journal: J Nucl Cardiol Date: 2009-08-01 Impact factor: 5.952