Altered regional myocardial metabolism in congestive cardiomyopathy detected by positron tomography

doi:10.1016/0002-9343(83)91065-3

The American Journal of Medicine

Volume 74, Issue 5, May 1983, Pages 773-785

https://doi.org/10.1016/0002-9343(83)91065-3 Get rights and content

Abstract

The present study was performed to determine whether positron emission tomography performed after intravenous injection of ¹¹C-palmitate permits detection and characterization of congestive cardiomyopathy. Positron emission tomography was performed after the intravenous injection of ¹¹C-palmitate in 13 normal subjects, 17 patients with congestive cardiomyopathy, and six patients with initial transmural myocardial infarction (defined electrocardtographically). Regionally depressed accumulation of ¹¹C-palmitate was assessed, characterized, and quantified in seven parallel transaxial reconstructions in each patient. Normal subjects exhibited homogeneous accumulation of ¹¹C-palmitate within the left ventricular myocardium, with smooth transitions in regional content of radioactivity. Patients with cardiomyopathy exhibited marked spatial heterogeneity of the accumulation of palmitate throughout the myocardium, easily distinguishable from that in normal subjects and distinct from that observed in patients with transmural infarction, in whom discrete regions of depressed accumulation of palmitate were observed with residual viable myocardium accumulating palmitate homogeneously. Patients with cardiomyopathy exhibited a larger number of discrete noncontiguous regions of accumulation of palmitate within the myocardium than either control subjects or patients with transmural infarction (17.4 ± 0.6 [SEM] versus 11.8 ± 0.7 versus 10.3 ± 0.6, p < 0.005). Similarly, regions of accumulation of palmitate were irregularly shaped in patients with cardiomyopathy, with a longer normalized perimeter than either control subjects or patients with transmural infarction (2.0 ± 0.05 versus 1.8 ± 0.06 versus 1.9 ± 0.09, p < 0.05). Regional abnormalities of the accumulation of ¹¹C-palmitate could not be explained by regional differences in left ventricular wall motion or myocardial perfusion. Thus, marked heterogeneity of regional myocardial accumulation of ¹¹C-palmitate is detectable and quantifiable in patients with congestive cardiomyopathy by positron emission tomography and may be particularly valuable for early detection and characterization of cardiomyopathy.

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^☆: This work was supported in part by NIH grants HL-17646, SCOR in Ischemic Heart Disease, and HL-13851.

¹: From the Cardiovascular Division and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.

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Clinical studyAltered regional myocardial metabolism in congestive cardiomyopathy detected by positron tomography☆

Abstract

Am J Cardiol

Am J Cardiol

Am J Cardiol

Med Clin North Am

The cardiomyopathies and myocarditites

Clarification of the cardiomyopathies

Mod Concepts Cardiovasc Dis

The pathology of cardiomyopathies. A critical analysis

Am Heart J

Postmortem findings and histologic, histochemical, and electron microscopic findings of myocardial biopsies

External detection and visualization of myocardial ischemia with 11C-substrates in vitro and in vivo

Circ Res

Detection of remote myocardial infarction in patients with positron emission transaxial tomography and intravenous 11C-palmitate

Circulation

External assessment of myocardial metabolism with (11C) palmitate in rabbit hearts

Am J Physiol

Regional assessment of myocardial metabolic integrity in vivo by positron-emission tomography with 11C-labeled palmitate

Circulation

Characterization of nontransmural myocardial infarction by positron emission tomography

Circulation

The role of the chemist in nuclear medicine

A multislice positron emission computed tomograph (PETT IV) yielding transverse and longitudinal images

Radiology

Statistical methods

Cardiac chamber imaging: a comparison of red blood cells labeled with Tc-99m in vitro and in vivo

J Nucl Med

Clinical study
Altered regional myocardial metabolism in congestive cardiomyopathy detected by positron tomography☆

External detection and visualization of myocardial ischemia with ¹¹C-substrates in vitro and in vivo

Detection of remote myocardial infarction in patients with positron emission transaxial tomography and intravenous ¹¹C-palmitate

External assessment of myocardial metabolism with (¹¹C) palmitate in rabbit hearts

Regional assessment of myocardial metabolic integrity in vivo by positron-emission tomography with ¹¹C-labeled palmitate