Background
The immune system orchestrates the repair of infarcted myocardium. Imaging of the cellular inflammatory response by 18F-FDG PET/MRI in the heart has been demonstrated in preclinical and clinical studies. However, the clinical relevance of post-MI 18F-FDG uptake in the heart has not been elucidated. The objective of this study was to explore the value of 18F-FDG-PET/MRI in patients after AMI as a biosignal for left ventricular functional outcome.
Methods and Results
We prospectively enrolled 49 patients with STEMI and performed 18F-FDG-PET/MRI 5 days after PCI and follow-up cardiac MRI after 6–9 months. In a subset of patients, 99mTc-sestamibi-SPECT was performed with tracer injection prior to revascularization. Cellular innate immune response was analyzed at multiple time points. Segmental comparison of 18F-FDG-uptake and LGE showed substantial overlap (κ=0.66), while quantitative analysis demonstrated that 18F-FDG extent exceeded LGE extent (33.2±16.2 %LV vs. 20.4±10.6 %LV, p<0.0001) and corresponded to the area-at-risk (r=0.87, p<0.0001). The peripheral blood count of CD14high/CD16+ monocytes correlated with the infarction size and 18F-FDG signal extent (r=0.53, p<0.002 and r=0.42, p<0.02, respectively). 18F-FDG uptake in the infarcted myocardium was highest in areas with transmural scar and the SUVmean was associated with left ventricular functional outcome independent of infarct size (ΔEF: p<0.04, ΔEDV: p<0.02, ΔESV: p<0.005).
Conclusions
In the current study, the intensity of 18F-FDG uptake in the myocardium after AMI correlated inversely with functional outcome at 6 months. Thus, 18F-FDG uptake in infarcted myocardium may represent a novel biosignal of myocardial injury.
The saccular membranes of trout (Oncorhynchus mykiss) and turbot (Scophthalmus maximus) were examined to characterize specialized epithelial cells that might be responsible for ion exchange. The approach for localizing cell types was new for this tissue, as observations were made with a stereomicroscope and a light microscope in order to have a general view of the epithelium. No important differences between the two species were seen. The saccular tissue is a monolayer epithelium (except for the macula neural zone) surrounded by a layer of connective tissue invaded by many blood vessels. The use of the fluorescent probe DAPSMI and zinc iodide/osmium fixation-coloration defined two areas in which ionocytes were present. In the first, large ionocytes were grouped into a nearly complete, crowned meshwork around, but separated from, the macula. In the second area, opposite the macula, the ionocytes were smaller, cubical, and grouped in patches. Cells rich in Na+, K+-ATPase and carbonic anhydrase II were present in both areas. Contrary to previous studies in mammals and fish, ionocytes were also found in the epithelium of the saccule.
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