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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Low-carbohydrate diet versus euglycemic hyperinsulinemic clamp for the assessment of myocardial viability with F-18-fluorodeoxyglucose-PET: a pilot study

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Author(s):
Soares, Jr., Jose [1] ; Rodrigues Filho, Filadelfo [1] ; Izaki, Marisa [1] ; Giorgi, Maria Clementina P. [1] ; Catapirra, Rosa M. A. [1] ; Abe, Rubens [1] ; Vinagre, Carmen G. C. M. [2] ; Cerri, Giovanni G. [1] ; Meneghetti, Jose Claudio [1]
Total Authors: 9
Affiliation:
[1] Univ Sao Paulo, Sch Med, Heart Inst InCor, Dept Nucl Med, BR-05403000 Sao Paulo - Brazil
[2] Univ Sao Paulo, Sch Med, Heart Inst InCor, Lipid Metab Lab, BR-05403000 Sao Paulo - Brazil
Total Affiliations: 2
Document type: Journal article
Source: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING; v. 30, n. 2, p. 415-423, FEB 2014.
Web of Science Citations: 4
Abstract

Positron emission tomography with F-18-fluorodeoxyglucose (FDG-PET) is considered the gold standard for myocardial viability. A pilot study was undertaken to compare FDG-PET using euglycemic hyperinsulinemic clamp before F-18-fluorodeoxyglucose (F-18-FDG) administration (PET-CLAMP) with a new proposed technique consisting of a 24-h low-carbohydrate diet before F-18-FDG injection (PET-DIET), for the assessment of hypoperfused but viable myocardium (hibernating myocardium). Thirty patients with previous myocardial infarction were subjected to rest Tc-99m-sestamibi-SPECT and two F-18-FDG studies (PET-CLAMP and PET-DIET). Myocardial tracer uptake was visually scored using a 5-point scale in a 17-segment model. Hibernating myocardium was defined as normal or mildly reduced metabolism (F-18-FDG uptake) in areas with reduced perfusion (Tc-99m-sestamibi uptake) since F-18-FDG uptake was higher than the degree of hypoperfusion-perfusion/metabolism mismatch indicating a larger flow defect. PET-DIET identified 79 segments and PET-CLAMP 71 as hibernating myocardium. Both methods agreed in 61 segments (agreement = 94.5 %, kappa = 0.78). PET-DIET identified 230 segments and PET-CLAMP 238 as nonviable. None of the patients had hypoglycemia after DIET, while 20 % had it during CLAMP. PET-DIET compared with PET-CLAMP had a good correlation for the assessment of hibernating myocardium. To our knowledge, these data provide the first evidence of the possibility of myocardial viability assessment with this technique. (AU)