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Myocardial Metabolic Changes in Hypertrophic Cardiomyopathy

Department of Nuclear Medicine and Third Division, Department of Internal Medicine, Kyoto University Faculty of Medicine, Kyoto, Japan
Department of Pediatrics, National Cardiovascular Center, Suita, Japan

Correspondence: For correspondence or reprints contact: Eiji Tadamura, MD, Department of Nuclear Medicine, Kyoto University Faculty of Medicine, Shogoin, Sakyo-ku, Kyoto, 606-01 Japan.

ABSTRACT

We evaluated myocardial blood flow, glucose and oxygen metabolism using PET in hypertrophic cardiomyopathy (HCM). Methods: PET studies using ¹⁸F-fluorodeoxyglucose (FDG) and ¹¹C-acetate were performed at rest in patients with HCM and normal subjects as a control group. The metabolic rate of glucose (MRGlu), K mono value as a marker of oxidative metabolism, and myocardial blood flow were estimated from serial dynamic FDG and ¹¹C-acetate PET studies. Results: Myocardial blood flow (%) did not differ significantly in hypertrophic and nonhypertrophic myocardium (90.3 ± 3.1 versus 91.7 ± 3.4). The MRGlu in hypertrophic myocardium, however, was lower than that in nonhypertrophic and normal myocardium (0.44 ± 0.10 versus 0.52 ± 0.15 and 0.53 ± 0.15 µmole/min/g, respectively, p < 0.05). The K mono values were also lower in hypertrophic myocardium than in nonypertrophic and normal myocardium (0.05 ± 0.010 versus 0.066 ± 0.0011 and 0.065 ± 0.017 per min, respectively, p < 0.05). The %FDG/%perfusion values in hypertrophic myocardium did not differ significantly from those in nonhypertrophic myocardium (0.96 ± 0.10 versus 1.02 ± 0.07). Conclusion: Myocardial ischemia at rest is observed less frequently in patients with HCM. Impairment of oxidative and glucose metabolism may precede decreased blood flow. Primary metabolic impairment is considered to be dominant in hypertrophic myocardium.

Key Words: PET • hypertrophic cardiomyopathy • myocardial metabolism • carbon-11-acetate • fluorine-18-FDG

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				S.-T. Li, C. J. Tack, L. Fananapazir, and D. S. Goldstein Myocardial perfusion and sympathetic innervation in patients with hypertrophic cardiomyopathy J. Am. Coll. Cardiol., June 1, 2000; 35(7): 1867 - 1873. [Abstract] [Full Text] [PDF]