Altered myocardial glucose utilization and the reverse mismatch pattern on rubidium-82 perfusion/F-18-FDG PET during the sub-acute phase following reperfusion of acute anterior myocardial infarction

作者：Anselm Daniel D; Anselm Anjali H; Renaud Jennifer; Atkins Harold L; de Kemp Robert; Burwash Ian G; Williams Kathryn A; Guo Ann; Kelly Cathy; DaSilva Jean; Beanlands Rob S B; Glover Christopher A^*

来源：Journal of Nuclear Cardiology, 2011, 18(4): 657-667.

DOI：10.1007/s12350-011-9389-5

• Myocardial infarction
• PCI
• glucose metabolism
• F-18-fluorodeoxyglucose
• PET

Reperfused myocardium post-acute myocardial infarction (AMI) may have altered metabolism with implications for therapy response and function recovery. We explored glucose utilization and the "reverse mismatch" (RMM) pattern (decreased F-18-fluorodeoxyglucose (FDG) uptake relative to perfusion) in patients who underwent mechanical reperfusion with percutaneous coronary intervention (PCI) for AMI.
Thirty-one patients with anterior wall AMI treated with acute reperfusion, with left ventricular ejection fraction a parts per thousand currency sign45%, underwent rest rubidium-82 (Rb-82) and FDG PET 2-10 days post-AMI. Resting echocardiograms were used to assess wall motion abnormalities. Significant RMM occurred in 15 (48%) patients and was associated with a shorter time to PCI of 2.9 hours (2.2, 13.3 hours) compared to patients without significant RMM: 11.4 hours (3.9, 22.4 hours) (P = .03). Within the peri-infarct regions, segments with significant RMM were more likely to have wall motion abnormalities (OR = 2.3 (1.1, 4.7), P = .02) compared to segments without significant RMM.
RMM is a common pattern on perfusion/FDG PET during the sub-acute phase following reperfusion of AMI and is associated with shorter times to PCI. Within the peri-infarct region, RMM occurs frequently and is more often associated with wall motion abnormalities than segments without RMM. Whether this represents a myocardial metabolic shift during the sub-acute phase of recovery warrants further study.

• 出版日期2011-8