Rubidium-82 Myocardial Uptake and Extraction After Transient Ischemia: PET Characteristics

The effects of transient regional ischemia on monovalent cation uptake and extraction by the myocardium were studied in seven open chest dogs. Following a 10-20% stenosis of the left anterior descending coronary artery to prevent reactive hyperemia, the regional myocardial uptake of the monovalent cation 82Rb (ml/min/g X extraction) was measured before, during, and at 10, 30, and 60-80 min after a 10 min total occlusion of the left anterior descending coronary artery using positron emission tomography. Regional myocardial blood flow was also measured at the same time interval using radiolabeled carbonized microspheres. The regional myocardial extraction of 82Rb was calculated as uptake/flow. In normally perfused myocardial regions there was an inverse relationship between 82Rb extraction and blood flow [extraction = -0.56 (In flow) + 0.46, r = 0.93] over a range of flow from 0.3 to 4 ml/min/g. During the prolonged recovery of 82Rb uptake in the transiently ischemic region, flow had returned to normal levels but 82Rb extraction at a given value of flow was significantly decreased at the 30 and 60-80 min times after release of the occlusion compared with normally perfused regions. Thus, prolonged abnormalities in the 82Rb uptake and extraction occur in myocardium recovering from transient ischemia.