Clinical Significance of Quantitative Assessment of Glucose Utilization in Patients with Ischemic Cardiomyopathy

Overview

Journal J Nucl Cardiol

Specialty Cardiology & Vascular Diseases

Date 2018 Aug 16

PMID 30109593

Citations 7

Authors

Kuan-Yin Ko

Shan-Ying Wang

Ruoh-Fang Yen

Yu-Chien Shiau

Jung-Cheng Hsu

Hao-Yuan Tsai

Chien-Lin Lee

Kuan-Ming Chiu

Yen-Wen Wu

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to prospectively quantify the rate of myocardial glucose uptake (MRGlu) in myocardium with different perfusion-metabolism patterns and determine its prognostic value in patients with ischemic cardiomyopathy.

Methods And Results: 79 patients with ischemic cardiomyopathy were prospectively enrolled for dynamic cardiac FDG PET, and then followed for at least 6 months. Perfusion-metabolism patterns were determined based on visual score analysis of Tl SPECT and FDG PET. MRGlu was analyzed using the Patlak kinetic model. The primary end-point was cardiovascular mortality. Significantly higher MRGlu was observed in viable compared with non-viable areas. Negative correlations were found between MRGlu in transmural match and a history of hyperlipidemia, statin usage, and triglyceride levels. Diabetic patients receiving dipeptidyl peptidase-4 inhibitors (DPP4i) had a significantly lower MRGlu in transmural match, mismatch, and reverse mismatch. Patients with MRGlu in transmural match ≥ 23.40 or reverse mismatch ≥ 36.90 had a worse outcome.

Conclusions: Myocardial glucose utilization was influenced by substrates and medications, including statins and DPP4i. MRGlu could discriminate between viable and non-viable myocardium, and MRGlu in transmural match and reverse mismatch may be prognostic predictors of cardiovascular death in patients with ischemic cardiomyopathy.

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