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Titolo:
CAN N-13 AMMONIA KINETIC MODELING DEFINE MYOCARDIAL VIABILITY INDEPENDENT OF F-18 FLUORODEOXYGLUCOSE
Autore:
BEANLANDS RSB; DEKEMP R; SCHEFFEL A; NAHMIAS C; GARNETT ES; COATES G; JOHANSEN HL; FALLEN E;
Indirizzi:
UNIV OTTAWA,INST HEART,DIV CARDIOL,CARDIAC PET CTR,ROOM H1-149,1053 CARLING AVE OTTAWA ON K1Y 4E9 CANADA MCMASTER UNIV,MED CTR,ES GARNETT MED IMAGING RES CTR,DIV CARDIOL HAMILTON ON CANADA MCMASTER UNIV,MED CTR,ES GARNETT MED IMAGING RES CTR,DIV NUCL MED HAMILTON ON CANADA
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 3, volume: 29, anno: 1997,
pagine: 537 - 543
SICI:
0735-1097(1997)29:3<537:CNAKMD>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITRON EMISSION TOMOGRAPHY; CORONARY-ARTERY DISEASE; BLOOD-FLOW; N-13 AMMONIA; NONINVASIVE QUANTIFICATION; INFARCT SIZE; PET; METABOLISM; PERFUSION; REST;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
R.S.B. Beanlands et al., "CAN N-13 AMMONIA KINETIC MODELING DEFINE MYOCARDIAL VIABILITY INDEPENDENT OF F-18 FLUORODEOXYGLUCOSE", Journal of the American College of Cardiology, 29(3), 1997, pp. 537-543

Abstract

Objectives. The hypothesis of this study was that evaluation of myocardial flow and metabolism using nitrogen-13 (N-13) ammonia kinetic modeling with dynamic positron emission tomographic (PET) imaging could identify regions of myocardial scar and viable myocardium as defined byfluorine-18 fluorodeoxyglucose (F-18 FDG) PET. Background. Uptake of most perfusion tracers depends on both perfusion and metabolic retention in tissue. This characteristic has limited their ability to differentiate myocardial scar from viable tissue. The kinetic modeling of N-13 ammonia permits quantification of blood how and separation of the metabolic component of its uptake, which may permit differentiation of scar from viable tissue. Methods. Sixteen patients, >3 months after myocardial infarction, underwent dynamic N-13 ammonia and F-18 FDG PET imaging. Regions of reduced and normal perfusion were defined on static N-13 ammonia images. Patients were classified into two groups (group I[ischemic viable], n = 6; group II [scar], n = 10) on the basis of percent of maximal F-18 FDG uptake in hypoperfused segments. Nitrogen-13ammonia kinetic modeling was applied to dynamic PET data, and rate constants were determined. Flow was defined by K-1; volume of distribution (VD = K-1/k(2)) of N-13 ammonia was used as an indirect indication of metabolic retention. Results. Fluorine-18 FDG uptake was reduced inpatients with scar compared with normal patients with ischemic viablezones (ischemic viable 93 +/- 27% [mean +/- SD]; scar 37 +/- 16%, p less than or equal to 0.01). Using N-13 ammonia kinetic modeling, how and VD were reduced in the hypoperfused regions of patients with scar (ischemic viable pow 0.65 +/- 0.20 ml/min per g; scar: 0.36 +/- 0.16 ml/min per g, p less than or equal to 0.01; VD: 3.9 +/- 1.3 and 2.0 +/- 1.07 ml/g, respectively, p less than or equal to 0.01). For detection of viable myocardium in these patients, the sensitivity and specificity were 100% and 80% for N-13 ammonia PET flow >0.45 ml/min per g; 100%and 70% for VD >2.0 ml/g; and 100% and 90% for both flow > 0.45 ml/min per g and VD > 2.0 ml/g, respectively. The positive and negative predictive values for the latter approach were 86% and 100%, respectively. Conclusions. In this cohort, patients having regions with flow less than or equal to 0.45 ml/min per g or VD less than or equal to 2.0 ml/g had scar. Viable myocardium had both flow >0.45 ml/min per g and VD > 2.0 ml/g. Nitrogen-13 ammonia kinetic modeling permits determinationof blood flow and metabolic integrity in patients with previous myocardial infarction and can help differentiate between scar and ischemic but viable myocardium. (C) 1997 by the American College of Cardiology.

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Documento generato il 19/01/20 alle ore 20:46:57