RT Journal Article SR Electronic T1 The prognostic value of myocardial glucose metabolism using dynamic FDG PET/CT in patients with ischemic cardiomyopathy JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 3378 OP 3378 VO 63 IS supplement 2 A1 Ko, Kuan-Yin A1 Wu, Yen-Wen YR 2022 UL http://jnm.snmjournals.org/content/63/supplement_2/3378.abstract AB 3378 Introduction: The aim of the study was to determine the prognostic value of the myocardial viability and glucose metabolism derived from dynamic cardiac FDG PET/CT in patients with ischemic cardiomyopathy. Methods: Consecutive patients with ischemic cardiomyopathy (left ventricular ejection fraction ≤40%) were studied with Tl-201 myocardial perfusion SPECT and glucose loaded insulin stimulated dynamic FDG PET/CT. Perfusion/metabolism patterns were determined based on visual analysis and classified as mismatch, transmural match and non-transmural match pattern, respectively. The glucose metabolic rate (MRGlu) was analyzed using the Patlak kinetic model. The primary end-point was the composite of major adverse cardiac events (MACEs), defined as the composite of total death, myocardial infarction, coronary revascularization, stroke, and hospitalization for heart failure. Improvement of LVEF≥5% was defined as functional recovery. Results: A total of 120 patients with ischemic cardiomyopathy were enrolled. MRGlu values were significantly lower in scar myocardium than in hibernating myocardium (25.7 ± 19.3 vs 19.9 ± 15.8, P = 0.02). MRGlu values in non-transmural scar myocardium were negatively correlated with LV functional recovery (r= -0.44, P = 0.03). During a median follow-up of 23.6 months, the number of transmural scar segment was an independent predictor of MACEs (HR: 1.2, 95% CI: 1.01-1.30). In the subgroup of 22 patients receiving revascularization following cardiac FDG PET, patients with higher MRGlu values in hibernating myocardium were associated with higher incidence of MACEs than those with lower values (cutoff: 20.8, Logrank test P: 0.01). Conclusions: In patients with ischemic cardiomyopathy, myocardial viability and glucose metabolism with dynamic FDG PET/CT might provide valuable prognostic information: (1) MRGlu values in non-transmural infarct myocardium were negatively associated with LV functional improvement, and (2) the glucose metabolism in hibernating myocardium is a predictor for MACEs following revascularization.