Assessment of Myocardial Viability by Use of
            <sup>11</sup>
            C-Acetate and Positron Emission Tomography

Wolpers, H. G.; Burchert, Wolfgang; Hoff, Jörg van den; Weinhardt, Regina; Meyer, G.-J.; Lichtlen, Paul R.

doi:10.1161/01.cir.95.6.1417

Cited by 67 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…FDG is a well-established tracer of metabolism, and its uptake has been shown to be a sensitive marker of myocardial viability. [42][43][44] None of the atria in the present study demonstrated any abnormality or regional defect in FDG Figure 4. PET images of atria from a dog in which phenol was applied.…”

Section: Pet Imagingmentioning

confidence: 44%

Heterogeneous Atrial Denervation Creates Substrate for Sustained Atrial Fibrillation

et al. 1998

View full text Add to dashboard Cite

Background-Heterogeneous electrophysiological properties, which may be due in part to autonomic innervation, are important in the maintenance of atrial fibrillation (AF). We hypothesized that heterogeneous sympathetic denervation with phenol would create a milieu for sustained AF. Methods and Results-After the determination of baseline inducibility, 15 dogs underwent atrial epicardial phenol application and 11 underwent a sham procedure. After 2 weeks of recovery, the animals had repeat attempts at inducing AF and effective refractory period (ERP) testing. Epicardial maps were obtained to determine local AF cycle lengths. ERPs were determined at baseline and during sympathetic, vagal, and simultaneous vagal/sympathetic stimulation.

show abstract

Section: Pet Imagingmentioning

confidence: 44%

Heterogeneous Atrial Denervation Creates Substrate for Sustained Atrial Fibrillation

et al. 1998

View full text Add to dashboard Cite

show abstract

“…Otherwise, oxygen use ultimately falls below a critical threshold, and dysfunctional myocardium becomes unsalvageable. 43,44 Conversely, in cases of timely revascularization, regional contractile function and consequently mechanical efficiency may be restored, which in turn is accompanied by improved prognosis. 45 More recently, metabolic interventions with drugs that increase glucose metabolism in ischemic heart disease have demonstrated that this energetically more favorable circumstance also translates into improved systolic function and improved clinical outcome.…”

Section: Knaapen Et Al Noninvasive Assessment Of Myocardial Efficiencymentioning

confidence: 99%

Myocardial Energetics and Efficiency

et al. 2007

View full text Add to dashboard Cite

T he heart is an aerobic organ that relies almost exclusively on the aerobic oxidation of substrates for generation of energy. Consequently, there is close coupling between myocardial oxygen consumption (MV O 2 ) and the main determinants of systolic function: heart rate, contractile state, and wall stress. 1 As in any mechanical pump, only part of the energy invested is converted to external power. In the case of the heart, the ratio of useful energy produced (ie, stroke work [SW]) to oxygen consumed is defined as mechanical efficiency, as originally proposed by Bing et al. 2 Under normal conditions this ratio is Ϸ25%, and the residual energy mainly dissipates as heat. 3 In pathophysiological disease states, such as heart failure, mechanical efficiency is reduced, and it has been hypothesized that the increased energy expenditure relative to work contributes to progression of the disease. 4,5 Moreover, therapeutic interventions that enhance mechanical efficiency have proven to be beneficial with respect to outcome. 6 It is therefore desirable to quantify efficiency of the heart to study disease processes and monitor interventions.Both cardiac oxidative metabolism and mechanical work, and thus efficiency, can be quantified through invasive measurements. Although these measurements are accurate and currently considered the gold standard, in clinical practice they are limited because of the need for dual-sided heart catheterization and selective catheterization of the coronary sinus. Recent advances in imaging techniques, however, offer the possibility to noninvasively estimate MV O 2 and mechanical work by positron emission tomography and echocardiography or by magnetic resonance imaging, respectively. This review discusses the principles of mechanical efficiency, together with its invasive and noninvasive assessment, as well as their strengths and pitfalls. Finally, results from clinical pathophysiological studies are discussed. Invasive Measurement of Mechanical EfficiencyTo calculate the efficiency of the heart, input and output energy must be obtained. The first can be derived from MV O 2 (mL O2 · min Ϫ1 ) measurements according to the Fickprinciple by multiplying coronary sinus blood flow (mL · min Ϫ1 ) by the arteriovenous oxygen content difference. 7Blood flow can be estimated with the use of thermodilution or Doppler (electromagnetic flowmeter) methods after accessing the coronary sinus through right-sided heart catheterization. As oxygen dissolved in blood is negligible and hemoglobin concentrations in arterial and venous blood are similar, arteriovenous oxygen content difference can be obtained by determination of the differences in oxygen saturation levels between arterial and coronary sinus blood. This method to determine oxygen utilization is currently considered the gold standard, although it should be noted that it is limited by its invasive nature, susceptibility to sampling errors, and the fact that only global MV O 2 can be assessed, which also includes oxidative metabolism of the right ventricl...

show abstract

“…Wolpers et al also determined threshold values for viability [89]. In contrast to other studies mentioned here, absolute MBF, derived from modelled acetate uptake rate and the Renkin-Crone equation from Armbrecht [33], was the best predictor of viability.…”

Section: Prediction Of Recovery Of Function By Acetate Clearancementioning

confidence: 54%

“…The acetate clearance and RPP were not significantly correlated in patients, whereas they were in volunteers (r=0.31 vs r=0. 89). This may have been due to the altered substrate availability in diabetic patients, with a significant effect on the work-MVO 2 relationship.…”

Section: Other Studiesmentioning

confidence: 99%

Carbon-11 acetate as a tracer of myocardial oxygen consumption

et al. 2001

View full text Add to dashboard Cite

Estimation of myocardial oxygen consumption (MVO2) and myocardial blood flow (MBF) is important for the understanding of various (patho)physiological mechanisms and diseases. Clearance rates of carbon-11 labelled acetate, determined with positron emission tomography, allow estimation of MVO2 on a segmental level and non-invasively. In addition, MBF can be determined from uptake rates. In this review, the background to estimation of MVO2 and MBF is discussed, as well as the currently available literature that has used 11C-acetate to estimate MVO2 and MBF.

show abstract

Assessment of Myocardial Viability by Use of ¹¹ C-Acetate and Positron Emission Tomography

Cited by 67 publications

References 26 publications

Heterogeneous Atrial Denervation Creates Substrate for Sustained Atrial Fibrillation

Heterogeneous Atrial Denervation Creates Substrate for Sustained Atrial Fibrillation

Myocardial Energetics and Efficiency

Carbon-11 acetate as a tracer of myocardial oxygen consumption

Contact Info

Product

Resources

About

Assessment of Myocardial Viability by Use of 11 C-Acetate and Positron Emission Tomography

Cited by 67 publications

References 26 publications

Heterogeneous Atrial Denervation Creates Substrate for Sustained Atrial Fibrillation

Heterogeneous Atrial Denervation Creates Substrate for Sustained Atrial Fibrillation

Myocardial Energetics and Efficiency

Carbon-11 acetate as a tracer of myocardial oxygen consumption

Contact Info

Product

Resources

About

Assessment of Myocardial Viability by Use of ¹¹ C-Acetate and Positron Emission Tomography