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- Title
Clinical significance of quantitative assessment of glucose utilization in patients with ischemic cardiomyopathy.
- Authors
Ko, Kuan-Yin; Wang, Shan-Ying; Yen, Ruoh-Fang; Shiau, Yu-Chien; Hsu, Jung-Cheng; Tsai, Hao-Yuan; Lee, Chien-Lin; Chiu, Kuan-Ming; Wu, Yen-Wen
- Abstract
<bold>Background: </bold>The aim of this study was to prospectively quantify the rate of myocardial glucose uptake (MRGlu) in myocardium with different perfusion-metabolism patterns and determine its prognostic value in patients with ischemic cardiomyopathy.<bold>Methods and Results: </bold>79 patients with ischemic cardiomyopathy were prospectively enrolled for dynamic cardiac FDG PET, and then followed for at least 6 months. Perfusion-metabolism patterns were determined based on visual score analysis of 201Tl SPECT and FDG PET. MRGlu was analyzed using the Patlak kinetic model. The primary end-point was cardiovascular mortality. Significantly higher MRGlu was observed in viable compared with non-viable areas. Negative correlations were found between MRGlu in transmural match and a history of hyperlipidemia, statin usage, and triglyceride levels. Diabetic patients receiving dipeptidyl peptidase-4 inhibitors (DPP4i) had a significantly lower MRGlu in transmural match, mismatch, and reverse mismatch. Patients with MRGlu in transmural match ≥ 23.40 or reverse mismatch ≥ 36.90 had a worse outcome.<bold>Conclusions: </bold>Myocardial glucose utilization was influenced by substrates and medications, including statins and DPP4i. MRGlu could discriminate between viable and non-viable myocardium, and MRGlu in transmural match and reverse mismatch may be prognostic predictors of cardiovascular death in patients with ischemic cardiomyopathy.
- Subjects
CARDIOMYOPATHIES; GLUCOSE; GLUCOSE metabolism; HEART metabolism; RESEARCH; MYOCARDIAL ischemia; RESEARCH methodology; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; RADIOPHARMACEUTICALS; SINGLE-photon emission computed tomography; DEOXY sugars; LONGITUDINAL method
- Publication
Journal of Nuclear Cardiology, 2020, Vol 27, Issue 1, p269
- ISSN
1071-3581
- Publication type
journal article
- DOI
10.1007/s12350-018-1395-4