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Metabolic Mismatch of Septal Beta-Oxidation and Glucose Utilization in Left Bundle Branch Block Assessed with PET

Department of Nuclear Medicine and Medical Clinic I, Technical University, Aachen, Germany
Institute of Chemistry, Research Center Jülich, Germany

Correspondence: For correspondence or reprints contact: Carsten Altehoefer, MD, Department of Radiology, Division Diagnostic Radiology, University Hospital, Hugstetter Str. 55, D-79106 Freiburg, Germany.

ABSTRACT

Preserved septal uptake of the new long-chain fatty acid analog [¹⁸F]THA was found in a patient with three-vessel disease, a history of previous anterior myocardial infarction and left bundle branch block (LBBB), despite severely decreased septal [¹⁸F]FDG uptake that suggested scarred tissue. Nearly absent [¹⁹F]FDG uptake in the septum could not be explained by concordant reduction of septal perfusion as assessed by ^99mTc-MIBI SPECT. These data may point to divergent metabolic effects of the conduction abnormality in LBBB with consecutively reduced septal exogenous glucose utilization but unaffected septal beta-oxidation.

Key Words: left bundle branch block • beta-oxidation • positron emission tomography • fluorine-18-fluorodeoxyglucose • fluorine-18-FTHA

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