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Myocardial Metabolism of Fluorodeoxyglucose Compared to Cell Membrane Integrity for the Potassium Analogue Rubidium-82 for Assessing Infarct Size in Man by PET

Department of Medicine, The University of Texas Medical School at Houston, Houston, Texas

Correspondence: For reprints contact: K. Lance Gould, MD, Division of Cardiology, Room 4.258 MSMB, University of Texas Medical School at Houston, Houston, Texas 77225.

ABSTRACT

Potassium loss from damaged myocardial cells is linearly related to CPK enzyme loss reflecting extent of necrosis. The potassium analog, rubidium-82 (⁸²Rb), is extracted after i.v. injection and retained in viable myocardium but is not trapped or washed out of necrotic regions. To compare myocardial cell metabolism with membrane dysfunction as indicators of necrosis/viability, 43 patients with evolving myocardial infarction and coronary arteriography had positron emission tomography using fluorodeoxyglucose (FDG) and the potassium analog ⁸²Rb. Percent of heart showing FDG defects and ⁸²Rb washout on sequential images indicating failure to retain the potassium analogue were visually assessed and quantified by automated software. Infarct size based on rubidium kinetics correlated closely with size and location on FDG images (visual r = 0.93, automated r = 0.82), suggesting that loss of cell membrane integrity for trapping the potassium analog ⁸²Rb parallels loss of intracellular glucose metabolism, both comparable quantitative markers of myocardial necrosis/viability.

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