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

Autor(es)

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]

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING; v. 30, n. 2, p. 415-423, FEB 2014.
• Citações Web of Science: 4

Resumo

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)

• Processo FAPESP: 04/13824-2 - Influência da dieta com baixo teor de carboidratos na pesquisa de viabilidade miocárdica com f-fluorodesoxi-glicose: estudo comparativo com o clamp hiperinsulínico euglicêmico
• Beneficiário: José Soares Júnior
• Modalidade de apoio: Auxílio à Pesquisa - Regular