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J Nucl Med. 2010; 51 (Supplement 2):1733
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Cardiovascular: Clinical Science

Cardiovascular-Clinical Posters

Myocardial oxidative metabolism in stunned myocardium after reperfusion therapy in acute coronary syndrome

Keiichiro Yoshinaga1, Masanao Naya1, Chietsugu Katoh1, Ken-ichi Nishijima1, Osamu Manabe1, Satoshi Yamada1, Hiroyuki Iwano1, Hiroyuki Tsutsui1 and Nagara Tamaki1

1 Hokkaido U. Graduate School of Medicine, Sapporo, Japan

Abstract No. 1733

Objectives: Myocardial stunning has been observed after reperfusion therapy in acute coronary syndrome (ACS). However, the mechanisms and myocardial metabolism of stunned myocardium have not been fully studied especially in subacute phase. A clearance rate of 11C acetate reflects myocardial oxygen consumption as oxidative metabolism. We aimed to clarify the oxidative metabolism in stunned myocardium by 11C acetate PET.

Methods: 17 patients (mean age 68.0±9.0 y) with acute coronary syndrome (ACS) after reperfusion underwent echocardiography, rest 99mTc sestamibi SPECT and rest 11C acetate PET within 2 weeks after ACS (8.1±2.6 days). Regional wall motion was estimated by 5-point scoring system (1; normal, 5: dyskinesis). Reperfused myocardium was divided into 3 categories such as normal, stunned (normal perfusion but reduced wall motion), and scar (reduced perfusion and wall motion). Oxidative metabolism was measured by the mono-exponential fit of the 11C acetate time-activity curve (kmono) and relative regional kmono was estimated.

Results: Among reperfused myocardium, both stunned (n=36) and scar (n=16) segments showed reduced regional wall motion compared to normal (n=37) (2.3±0.6, 2.7±0.9 vs 1.0±0, P<0.05). Both kmono and relative kmono was lower in stunned myocardium (0.042±0.01/min and 67.7±14.7%) than normal (0.051±0.009/min and 82.5±9.3%, p<0.05 each). Such reduction was similar with those in scar segments (0.039±0.01/min, ns, 58.9±18.2%, P<0.05 vs. normal). There was no significant difference in both index between stunned and scar segments.

Conclusions: Stunned myocardium showed reduced oxidative metabolism similarly with those of scar tissue. In stunned myocardium, myocardial oxidative metabolism depended on regional function rather than perfusion. This may indicate cardiac protective effect after ischemic injury





This Article
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Right arrow Alert me to new issues of the journal
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Right arrow Articles by Yoshinaga, K.
Right arrow Articles by Tamaki, N.
PubMed
Right arrow Articles by Yoshinaga, K.
Right arrow Articles by Tamaki, N.