Title |
Low-carbohydrate diet versus euglycemic hyperinsulinemic clamp for the assessment of myocardial viability with 18F-fluorodeoxyglucose-PET: a pilot study
|
---|---|
Published in |
The International Journal of Cardiovascular Imaging, November 2013
|
DOI | 10.1007/s10554-013-0324-5 |
Pubmed ID | |
Authors |
José Soares, Filadelfo Rodrigues Filho, Marisa Izaki, Maria Clementina P. Giorgi, Rosa M. A. Catapirra, Rubens Abe, Carmen G. C. M. Vinagre, Giovanni G. Cerri, José Cláudio Meneghetti |
Abstract |
Positron emission tomography with (18)F-fluorodeoxyglucose (FDG-PET) is considered the gold standard for myocardial viability. A pilot study was undertaken to compare FDG-PET using euglycemic hyperinsulinemic clamp before (18)F-fluorodeoxyglucose ((18)F-FDG) administration (PET-CLAMP) with a new proposed technique consisting of a 24-h low-carbohydrate diet before (18)F-FDG injection (PET-DIET), for the assessment of hypoperfused but viable myocardium (hibernating myocardium). Thirty patients with previous myocardial infarction were subjected to rest (99m)Tc-sestamibi-SPECT and two (18)F-FDG studies (PET-CLAMP and PET-DIET). Myocardial tracer uptake was visually scored using a 5-point scale in a 17-segment model. Hibernating myocardium was defined as normal or mildly reduced metabolism ((18)F-FDG uptake) in areas with reduced perfusion ((99m)Tc-sestamibi uptake) since (18)F-FDG uptake was higher than the degree of hypoperfusion-perfusion/metabolism mismatch indicating a larger flow defect. PET-DIET identified 79 segments and PET-CLAMP 71 as hibernating myocardium. Both methods agreed in 61 segments (agreement = 94.5 %, κ = 0.78). PET-DIET identified 230 segments and PET-CLAMP 238 as nonviable. None of the patients had hypoglycemia after DIET, while 20 % had it during CLAMP. PET-DIET compared with PET-CLAMP had a good correlation for the assessment of hibernating myocardium. To our knowledge, these data provide the first evidence of the possibility of myocardial viability assessment with this technique. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 21 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 4 | 19% |
Student > Doctoral Student | 3 | 14% |
Other | 2 | 10% |
Student > Ph. D. Student | 2 | 10% |
Student > Master | 1 | 5% |
Other | 3 | 14% |
Unknown | 6 | 29% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 8 | 38% |
Agricultural and Biological Sciences | 2 | 10% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 5% |
Unspecified | 1 | 5% |
Nursing and Health Professions | 1 | 5% |
Other | 0 | 0% |
Unknown | 8 | 38% |