| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Departments of Clinical Physiology, Medicine, Radiology and Turku Medical PET Research Center, University of Turku, Turku, Finland
Correspondence: For reprints contact: Dr. Juhani Knuuti, Department of Clinical Physiology, Turku University Central Hospital, SF-20520 Turku, Finland.
ABSTRACT
To enable assessment of myocardial viability, myocardial glucose utilization has commonly been stimulated by oral glucose loading. To compare the effects of glucose loading and insulin and glucose infusion (insulin clamp) on PET fluorodeoxyglucose ([18F]FDG) myocardial scan image quality and regional myocardial glucose utilization rate (rMGU), eight patients with angiographically documented coronary artery disease and previous myocardial Q-wave infarction were studied twice, once during insulin clamp and once 1 hr after oral glucose loading. The rMGU rates were derived by graphic Patlak analysis in 33 normal, 10 scar and 6 "hot spot" myocardial segments. Infusion of insulin and glucose gave stable plasma-glucose and serum-insulin levels during imaging. In contrast, glucose loading caused marked changes in plasma-glucose and insulin concentrations. The image quality was clearly superior and the fractional utilization rates of [18FF]FDG were twice as high during insulin clamp than after glucose loading (p < 0.0001). Due to the higher plasma-glucose levels after glucose loading, the calculated rMGU in normal, scar and hot spot myocardial segments was comparable between the two protocols. The insulin clamp technique makes it possible to adjust and maintain a metabolic steady state during the PET study. It does not alter [18FF]FDG uptake patterns in different myocardial areas when compared to the standard glucose loading protocol, but this technique results in superior image quality and permits the use of smaller [18FF]FDG patient doses.
This article has been cited by other articles:
|
|
 |
|
  R. Lautamaki, R. Borra, P. Iozzo, M. Komu, T. Lehtimaki, M. Salmi, S. Jalkanen, K. E. J. Airaksinen, J. Knuuti, R. Parkkola, et al. Liver steatosis coexists with myocardial insulin resistance and coronary dysfunction in patients with type 2 diabetes Am J Physiol Endocrinol Metab, August 1, 2006; 291(2): E282 - E290. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Wiggers, H. Norrelund, S. S. Nielsen, N. H. Andersen, J. E. Nielsen-Kudsk, J. S. Christiansen, T. T. Nielsen, N. Moller, and H. E. Botker Influence of insulin and free fatty acids on contractile function in patients with chronically stunned and hibernating myocardium Am J Physiol Heart Circ Physiol, August 1, 2005; 289(2): H938 - H946. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.R. Underwood, J. J Bax, J. v. Dahl, M. Y Henein, A. C van Rossum, E. R Schwarz, J.-L. Vanoverschelde, E. E.v. d. Wall, and W. Wijns Imaging techniques for the assessment of myocardial hibernation: Report of a Study Group of the European Society of Cardiology Eur. Heart J., May 2, 2004; 25(10): 815 - 836. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. P. van der Weerdt, R. Boellaard, P. Knaapen, C. A. Visser, A. A. Lammertsma, and F. C. Visser Postinjection Transmission Scanning in Myocardial 18F-FDG PET Studies Using Both Filtered Backprojection and Iterative Reconstruction J. Nucl. Med., February 1, 2004; 45(2): 169 - 175. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H.J.A. Slart, J. J. Bax, R. M. de Jong, J. de Boer, H. J. Lamb, P. H. Mook, A. T.M. Willemsen, W. Vaalburg, D. J. van Veldhuisen, and P. L. Jager Comparison of Gated PET with MRI for Evaluation of Left Ventricular Function in Patients with Coronary Artery Disease J. Nucl. Med., February 1, 2004; 45(2): 176 - 182. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Herreros, F. Prosper, A. Perez, J. J Gavira, M. J. Garcia-Velloso, J. Barba, P. L Sanchez, C. Canizo, G. Rabago, J. M Marti-Climent, et al. Autologous intramyocardial injection of cultured skeletal muscle-derived stem cells in patients with non-acute myocardial infarction Eur. Heart J., November 2, 2003; 24(22): 2012 - 2020. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. L.R. Kam, R. Valkema, D. Poldermans, J. J. Bax, A. E.M. Reijs, R. Rambaldi, E. Boersma, T. Rietveld, J. R.T.C. Roelandt, and E. P. Krenning Feasibility and Image Quality of Dual-Isotope SPECT Using 18F-FDG and 99mTc-Tetrofosmin After Acipimox Administration J. Nucl. Med., February 1, 2003; 44(2): 140 - 145. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Luss, M. Schafers, J. Neumann, D. Hammel, C. Vahlhaus, H. A Baba, F. Janssen, H. H Scheld, O. Schober, G. Breithardt, et al. Biochemical mechanisms of hibernation and stunning in the human heart Cardiovasc Res, December 1, 2002; 56(3): 411 - 421. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.L Gerber, F.F Ordoubadi, W Wijns, J.-L.J Vanoverschelde, M.J Knuuti, M Janier, P Melon, P.K Blanksma, A Bol, J.J Bax, et al. Positron emission tomography using18F-fluoro-deoxyglucose and euglycaemic hyperinsulinaemic glucose clamp: optimal criteria for the prediction of recovery of post-ischaemic left ventricular dysfunction. Results from the European Community Concerted Action Multicenter study on use of18F-fluoro-deoxyglucose Positron Emission Tomography for the Detection of Myocardial Viability Eur. Heart J., September 2, 2001; 22(18): 1691 - 1701. [Abstract] [PDF]
|
|
|
|
|
|
K. Yoshinaga, K. Morita, S. Yamada, K. Komuro, C. Katoh, Y. Ito, Y. Kuge, T. Kohya, A. Kitabatake, and N. Tamaki Low-Dose Dobutamine Electrocardiograph-Gated Myocardial SPECT for Identifying Viable Myocardium: Comparison with Dobutamine Stress Echocardiography and PET J. Nucl. Med., June 1, 2001; 42(6): 838 - 844. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. F. Maes, F. Van de Werf, L. V. Mesotten, P. B. Flamen, R. S. Kuzo, J. L. Nuyts, and L. Mortelmans Early assessment of regional myocardial blood flow and metabolism in thrombolysis in myocardial infarction flow grade 3 reperfused myocardial infarction using carbon-11-acetate J. Am. Coll. Cardiol., January 1, 2001; 37(1): 30 - 36. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-M. J. Siebelink, P. K. Blanksma, H. J. G. M. Crijns, J. J. Bax, A. J. van Boven, T. Kingma, D. A. Piers, J. Pruim, P. L. Jager, W. Vaalburg, et al. No difference in cardiac event-free survival between positron emission tomography-guided and single-photon emission computed tomography-guided patient management: A prospective, randomized comparison of patients with suspicion of jeopardized myocardium J. Am. Coll. Cardiol., January 1, 2001; 37(1): 81 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bogaert, H. Bosmans, A. Maes, P. Suetens, G. Marchal, and F. E. Rademakers Remote myocardial dysfunction after acute anterior myocardial infarction: impact of left ventricular shape on regional function: A magnetic resonance myocardial tagging study J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1525 - 1534. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kuhn, F.H. Gietzen, M. Schafers, M. Freick, B. Gockel, C. Strunk-Muller, E. Jachmann, and O. Schober Changes in the left ventricular outflow tract after transcoronary ablation of septal hypertrophy (TASH) for hypertrophic obstructive cardiomyopathy as assessed by transoesophageal echocardiography and by measuring myocardial glucose utilization and perfusion Eur. Heart J., December 2, 1999; 20(24): 1808 - 1817. [Abstract] [PDF]
|
|
|
|
 |
|
 E BARNES and P G CAMICI Prevalence of hibernating myocardium in patients with severely impaired ischaemic left ventricles Heart, October 1, 1999; 82(4): 534c - 534. [Full Text]
|
|
|
|
 |
|
 H. Jadvar, H. W. Strauss, and G. M. Segall SPECT and PET in the Evaluation of Coronary Artery Disease RadioGraphics, July 1, 1999; 19(4): 915 - 926. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Schoder, R. Campisi, T. Ohtake, C. K. Hoh, D. H. Moon, J. Czernin, and H. R. Schelbert Blood flow-metabolism imaging with positron emission tomography in patients with diabetes mellitus for the assessment of reversible left ventricular contractile dysfunction J. Am. Coll. Cardiol., April 1, 1999; 33(5): 1328 - 1337. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Bogaert, A. Maes, F. Van de Werf, H. Bosmans, M.-C. Herregods, J. Nuyts, W. Desmet, L. Mortelmans, G. Marchal, and F. E. Rademakers Functional Recovery of Subepicardial Myocardial Tissue in Transmural Myocardial Infarction After Successful Reperfusion : An Important Contribution to the Improvement of Regional and Global Left Ventricular Function Circulation, January 12, 1999; 99(1): 36 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Al-Mohammad, I R Mahy, M Y Norton, G Hillis, J C Patel, P Mikecz, and S Walton Prevalence of hibernating myocardium in patients with severely impaired ischaemic left ventricles Heart, December 1, 1998; 80(6): 559 - 564. [Abstract] [Full Text]
|
|
|
|
|
|
T. Doenst, Q. Han, G. W. Goodwin, P. H. Guthrie, and H. Taegtmeyer Insulin does not change the intracellular distribution of hexokinase in rat heart Am J Physiol Endocrinol Metab, October 1, 1998; 275(4): E558 - E567. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Doenst and H. Taegtmeyer Profound Underestimation of Glucose Uptake by [18F]2-Deoxy-2-fluoroglucose in Reperfused Rat Heart Muscle Circulation, June 23, 1998; 97(24): 2454 - 2462. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T. Maki, M. T. Haaparanta, M. S. Luotolahti, P. Nuutila, L.-M. Voipio-Pulkki, J. R. Bergman, O. H. Solin, and J. M. Knuuti Fatty acid uptake is preserved in chronically dysfunctional but viable myocardium Am J Physiol Heart Circ Physiol, November 1, 1997; 273(5): H2473 - H2480. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Depre, J.-L. J. Vanoverschelde, B. Gerber, M. Borgers, J. A. Melin, and R. Dion CORRELATION OF FUNCTIONAL RECOVERY WITH MYOCARDIAL BLOOD FLOW, GLUCOSE UPTAKE, AND MORPHOLOGIC FEATURES IN PATIENTS WITH CHRONIC LEFT VENTRICULAR ISCHEMIC DYSFUNCTION UNDERGOING CORONARY ARTERY BYPASS GRAFTING J. Thorac. Cardiovasc. Surg., February 1, 1997; 113(2): 371 - 378. [Abstract] [Full Text]
|
|
|
|
|
|
B. L. Gerber, J.-L. J. Vanoverschelde, A. Bol, C. Michel, D. Labar, W. Wijns, and J. A. Melin Myocardial Blood Flow, Glucose Uptake, and Recruitment of Inotropic Reserve in Chronic Left Ventricular Ischemic Dysfunction: Implications for the Pathophysiology of Chronic Myocardial Hibernation Circulation, August 15, 1996; 94(4): 651 - 659. [Abstract] [Full Text]
|
|
|
|
|
|
M. Maki, M. Luotolahti, P. Nuutila, H. Iida, L.-M. Voipio-Pulkki, U. Ruotsalainen, M. Haaparanta, O. Solin, J. Hartiala, R. Harkonen, et al. Glucose Uptake in the Chronically Dysfunctional but Viable Myocardium Circulation, May 1, 1996; 93(9): 1658 - 1666. [Abstract] [Full Text]
|
|
|
|
|
|
N. V.S. Marinho, B. E. Keogh, D. C. Costa, A. A. Lammerstma, P. J. Ell, and P. G. Camici Pathophysiology of Chronic Left Ventricular Dysfunction : New Insights From the Measurement of Absolute Myocardial Blood Flow and Glucose Utilization Circulation, February 15, 1996; 93(4): 737 - 744. [Abstract] [Full Text]
|
|
|
|
|
|
A. Maes, F. Van de Werf, J. Nuyts, G. Bormans, W. Desmet, and L. Mortelmans Impaired Myocardial Tissue Perfusion Early After Successful Thrombolysis : Impact on Myocardial Flow, Metabolism, and Function at Late Follow-up Circulation, October 15, 1995; 92(8): 2072 - 2078. [Abstract] [Full Text]
|
|
|
|
|
|
K. Clarke and R. L. Veech Metabolic Complexities in Cardiac Imaging Circulation, May 1, 1995; 91(9): 2299 - 2301. [Full Text]
|
|
|
|
|
|
R. Hariharan, M. Bray, R. Ganim, T. Doenst, G. W. Goodwin, and H. Taegtmeyer Fundamental Limitations of [18F]2-Deoxy-2-Fluoro-D-Glucose for Assessing Myocardial Glucose Uptake Circulation, May 1, 1995; 91(9): 2435 - 2444. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. Th. Locher, L. D. Frey, K. Seybold, and H. Jenzer Myocardial 18F-FDG-PET: Experiences with the Euglycemic Hyperinsulinemic Clamp Technique Angiology, April 1, 1995; 46(4): 313 - 320. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
