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Journal of Nuclear Medicine Vol. 46 No. 4 553-559
© 2005 by Society of Nuclear Medicine

Clinical Investigations

Myocardial 11C-Diacylglycerol Accumulation and Left Ventricular Remodeling in Patients After Myocardial Infarction

Hiroki Otani, MD, PhD1, Yutaka Kagaya, MD, PhD1, Yoshio Imahori, MD, PhD2, Satoshi Yasuda, MD, PhD3, Ryo Fujii, PhD4, Masanobu Chida, MD, PhD1, Shigeto Namiuchi, MD, PhD1, Morihiko Takeda, MD, PhD1, Masahito Sakuma, MD, PhD1, Jun Watanabe, MD, PhD1, Tatsuo Ido, PhD5, Hiroshi Nonogi, MD, PhD3 and Kunio Shirato, MD, PhD1

1 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
2 Department of Neurosurgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
3 Division of Cardiology, National Cardiovascular Center, Osaka, Japan
4 Nishijin Hospital, Kyoto, Japan
5 Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan

Left ventricular (LV) remodeling after myocardial infarction (MI) is a maladaptive process that increases the risk of heart failure and death. The myocardial phosphoinositide cycle, which is located downstream from several neurohumoral factors, plays a crucial role in LV remodeling. Our animal studies demonstrated that 1-[1-11C]butyryl-2-palmitoyl-rac-glycerol (11C-DAG) can be used to visualize regions with an activated phosphoinositide cycle. Therefore, we examined whether myocardial 11C-DAG accumulation assessed by PET is relevant to LV enlargement and systolic dysfunction in post-MI patients. Methods: We performed PET with 11C-DAG in 13 post-anteroseptal MI patients and 4 healthy volunteers. We placed regions of interest on the noninfarcted myocardium and calculated the myocardium-to-left atrial (LA) chamber ratio of 11C-DAG accumulation. Results: The myocardium-to-LA chamber ratio of 11C-DAG was significantly higher in the post-MI patients (mean ± SD, 1.73 ± 0.35) compared with that of the healthy volunteers (mean ± SD, 1.25 ± 0.13; P < 0.05). In the post-MI patients, the myocardium-to-LA chamber ratio of 11C-DAG was significantly correlated with the LV end-diastolic volume index (r = 0.79, P < 0.01) and the plasma concentration of brain natriuretic peptide (r = 0.85, P < 0.001) and negatively correlated with the LV ejection fraction (r = –0.69, P < 0.01). Conclusion: These findings suggest that the myocardial 11C-DAG accumulation assessed by PET is relevant to LV enlargement, LV systolic dysfunction, and humoral activation in post-MI patients. This new imaging strategy based on intracellular signaling may contribute to the assessment and treatment of post-MI patients.

Key Words: myocardial infarction • ventricular remodeling • signal transduction


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