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Recovery of Perfusion, Glucose Utilization and Fatty Acid Utilization in Stunned Myocardium

First Department of Internal Medicine, Department of Radiology, Biomedical Imaging Research Center, Fukui; Fukui Medical University, Fukui, Japan

Correspondence: For correspondence or reprints contact: Jong-Dae Lee, MD, First Department of Internal Medicine, Fukui Medical School, 23 Shimoaizuki, Matsuoka-cho, Fukui, 910-11, Japan.

ABSTRACT

We describe the clinical features and results of cardiac catheterization, PET ([¹³N]ammonia, ¹⁸F-fluorodeoxyglucose (FDG)) and SPECT [¹²³I-labeled 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP)], in a patient with acute myocardial infarction successfully treated with intracoronary thrombolytic therapy. We compared the clinical and electrocardiographic changes with the myocardial glucose and fatty acid metabolism in stunned myocardium over a period of several months. The patient we studied illustrates the features of stunned myocardium. In the subacute phase, there was a concordant depression of myocardial [¹³N]ammonia and FDG uptake, and the metabolic abnormalities persisted even after regional wall motion at rest had returned to normal. The electrocardiographic recovery of deep negative T waves appeared to be related to the metabolic recovery in regions of stunned myocardium in this patient.

Key Words: PET • fluorine-18-fluorodeoxyglucose • iodine-123-BMIPP • stunned myocardium

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