Clinical significance of quantitative assessment of glucose utilization in patients with ischemic cardiomyopathy
Journal
Journal of Nuclear Cardiology
Journal Volume
27
Journal Issue
1
Pages
269-279
Date Issued
2020
Author(s)
Abstract
Background: 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. Methods and Results: 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. Conclusions: 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. ? 2018, American Society of Nuclear Cardiology.
SDGs
Other Subjects
acetylsalicylic acid; aminophylline; clopidogrel; creatinine; dipeptidyl peptidase IV inhibitor; dipyridamole; fluorodeoxyglucose f 18; glucose; hemoglobin A1c; high density lipoprotein cholesterol; insulin; low density lipoprotein cholesterol; thallium 201; fluorodeoxyglucose f 18; glucose; radiopharmaceutical agent; adult; Article; cardiac gated imaging; cardiac muscle; cardiovascular mortality; cohort analysis; controlled study; coronary angiography; correlational study; diabetic patient; female; glucose blood level; glucose transport; glucose utilization; heart muscle ischemia; human; hyperlipidemia; image quality; ischemic cardiomyopathy; limit of quantitation; major clinical study; male; middle aged; positron emission tomography; priority journal; prognosis; prospective study; quantitative analysis; scar formation; single photon emission computed tomography; transthoracic echocardiography; triacylglycerol level; aged; diagnostic imaging; heart muscle ischemia; metabolism; very elderly; Adult; Aged; Aged, 80 and over; Cohort Studies; Female; Fluorodeoxyglucose F18; Glucose; Humans; Male; Middle Aged; Myocardial Ischemia; Myocardium; Positron-Emission Tomography; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon
Type
journal article