Decreased glycolytic metabolism in non-compaction cardiomyopathy by F-18-fluoro-2-deoxyglucose positron emission tomography: new insights into pathophysiological mechanisms and clinical implications

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Tavares de Melo, Marcelo Dantas ; Pinto Giorgi, Maria Clementina ; Assuncao, Jr., Antonildes Nascimento ; Dantas, Jr., Roberto Nery ; Araujo Filho, Jose de Arimateia ; Parga Filho, Jose Rodrigues ; de Souza Bierrenbach, Ana Luiza ; de Lima, Camila Rocon ; Soares, Jr., Jose ; Meneguetti, Jose Claudio ; Mady, Charles ; Hajjar, Ludhmila Abrahao ; Kalil Filho, Roberto ; Bocchi, Edimar Alcides ; Cury Salemi, Vera Maria

• Document type: Journal article
• Source: EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING; v. 18, n. 8, p. 915-921, AUG 2017.
• Web of Science Citations: 1

Abstract

Aims The pathophysiological mechanisms of left ventricular non-compaction cardiomyopathy (LVNC) remain controversial. This study performed combined F-18-fluoro-2-deoxyglucose dynamic positron emission tomography (FDG-PET) and 99mTc-sestamibi single-photon emission computed tomography (SPECT) studies to evaluate myocardial glucose metabolism and perfusion in patients with LVNC and their clinical implications. Methods and results Thirty patients (41 +/- 12 years, 53% male) with LVNC, diagnosed by cardiovascular magnetic resonance (CMR) criteria, and eight age-matched healthy controls (42 +/- 12 years, 50% male) were prospectively recruited to undergo FDG-PET with measurement of the myocardial glucose uptake rate (MGU) and SPECT to investigate perfusion-metabolism patterns. Patients with LVNC had lower global MGU compared with that in controls (36.9 +/- 8.8 vs. 44.6 +/- 5.4 mu mol/min/100 g, respectively, P = 0.02). Of 17 LV segments, MGU levels were significantly reduced in 8, and also a reduction was observed when compacted segments from LVNC were compared with the segments from control subjects (P < 0.001). Perfusion defects were also found in 15 (50%) patients (45 LV segments: 64.4% match, and 35.6% mismatch perfusion-metabolism pattern). Univariate and multivariate analyses showed that beta-blocker therapy was associated with increased MGU (beta coefficient = 10.1, P = 0.008). Moreover, a gradual increase occurred in MGU across the beta-blocker dose groups (P for trend = 0.01). Conclusion The reduction of MGU documented by FDG-PET in LVNC supports the hypothesis that a cellular metabolic pathway may play a role in the pathophysiology of LVNC. The beneficial effect of beta-blocker mediating myocardial. (AU)

• FAPESP's process: 10/18939-3 - Microcirculatory and glycolytic metabolism evaluation in isolated noncompaction cardiomyopathy
• Grantee: Vera Maria Cury Salemi
• Support Opportunities: Regular Research Grants