C-11 labeled palmitic acid for the noninvasive evaluation of regional myocardial fatty acid metabolism with positron-computed tomography

Schön, H. R.; Schelbert, Heinrich R.; Robinson, G. D.; Najafi, Ahmad; Huang, Sung‐Cheng; Hansen, Herbert; Barrio, Jorge R.; Kuhl, David E.; Phelps, Michael E.

doi:10.1016/0002-8703(82)90341-6

Cited by 142 publications

(29 citation statements)

References 32 publications

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“…Fatty acid and exogenous glucose utilizations have been fully investigated with PET using Correspondence to: N. Tamaki carbon-ll palmitate [1][2][3] and fluorine-18 2-fluoro-2-deoxyglucose (FDG) [4][5][6][7]. [1 t C]Acetate permits evaluation of flux through the tricarboxylic acid (TCA) cycle, and thus, estimation of myocardial oxygen consumption [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Oxidative metabolism in the myocardium in normal subjects during dobutamine infusion

et al. 1993

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To assess the biventricular response of the clearance rate of carbon-11 acetate as an index of myocardial oxidative metabolism to increase in work-load, dynamic positron emission tomography was performed at rest and during dobutamine infusion in 14 normal subjects. The clearance rate constant (Kmono) of the left ventricular (LV) myocardium increased during dobutamine infusion (0.112 +/- 0.020 min-1 vs 0.065 +/- 0.015 min-1 at rest) (P < 0.001) in proportion to the increase in the pressure-rate product. Kmono in the right ventricular (RV) myocardium also increased (0.080 +/- 0.018 min-1 vs 0.034 +/- 0.013 min-1 at rest) (P < 0.001), with an excellent correlation with the LV Kmono (r = 0.920). The fact that the increase in RV Kmono during dobutamine infusion was greater (158% +/- 81%) than that in LV Kmono (79% +/- 39%) (P < 0.005) indicates a greater increase in oxidative metabolism in the RV in response to inotropic stimulation in normal subjects.

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Section: Introductionmentioning

confidence: 99%

Oxidative metabolism in the myocardium in normal subjects during dobutamine infusion

et al. 1993

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“…Analysis of externally detected myocardial time-activity curves following the injection of radiolabelled fatty acids reveals an initial vascular phase with rapid myocardial tracer uptake followed by two elimination phases (Sch6n et al 1982). The first of these elimination phases is believed to be related to beta oxidation, and the second slower elimination phase is attributed to the elimination of radiolabelled fatty acids initially incorporated into the intracellular lipid stores.…”

Section: Myocardial Ippa Clearancementioning

confidence: 99%

Myocardial scintigraphy with iodine-123 phenylpentadecanoic acid and thallium-201 in patients with coronary artery disease: a comparative dual-isotope study

et al. 1992

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To characterise the clinical usefulness of serial myocardial scintigraphy with iodine-123 phenylpentadecanoic acid (IPPA) in comparison with thallium-201, dual-isotope investigations were performed in 41 patients with angiographically documented coronary artery disease. Both tracers were administered simultaneously during symptom-limited ergometry. Planar scintigrams were acquired immediately after stress, and delayed imaging was performed after 1 h for IPPA and 4 h for 201Tl. Scintigrams were evaluated both qualitatively and quantitatively using a newly developed algorithm for automated image superposition. Initial myocardial uptake of both tracers was closely correlated (r = 0.75, p < 0.001). Both tracers also revealed a similar sensitivity for the identification of individual coronary artery stenoses > or = 75% (IP-PA: 70.0%, 201Tl: 66.3%, P = NS) with identical specificity (69.8%). The number of persistent defects, however, was significantly higher with IPPA (P = 0.021), suggesting that visual analysis of serial IPPA scintigrams may overestimate the presence of myocardial scar tissue. On the other hand, previous Q wave myocardial infarction was associated with a decreased regional IPPA clearance (29% +/- 11% vs 44% +/- 11% in normal myocardium, P < 0.05). The data indicate that serial myocardial scintigraphy with IPPA is essentially as sensitive as scintigraphy with 201Tl for the detection of stress-induced perfusion abnormalities. Quantitative analysis of myocardial IPPA kinetics, however, is required for the evaluation of tissue viability.

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“…Palmitate is a saturated 16-carbon fatty acid that is present in most natural fats. Its initial uptake is flow dependent, as its extraction is high (30-60% [4][5][6]. Activity clearance is biexponential, and the rapid clearance curve component is thought to represent palmitate oxidation, while the slow clearance phase corresponds to incorporation of the radiolabel into the phospholipid and triglyceride pools.…”

Section: Fatty Acid Metabolismmentioning

confidence: 99%

“…~C acetate that is highly extracted (40%) [8] and is metabolized only by the TCA cycle has been proposed as a more direct reflection of myocardial oxidative metabolism [9,10]. Experimentally, Brown et al [4] and Buxton et al [5] compared acetate clearance with MV02. K~, the rate constant of the early rapid phase, correlates with MVO2 and is only minimally influenced by myocardial substrate availability.…”

Section: Fatty Acid Metabolismmentioning

confidence: 99%

Imaging of myocardial metabolism by positron emission tomography

Rigo

Landsheere

Mélon

et al. 1990

Cardiovasc Drug Ther

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Tracer techniques have provided new insight in cardiology by allowing noninvasive studies of myocardial perfusion, function, metabolism, and, more recently, ligand-receptor interaction. Positron emission tomography allows accurate quantification and the use of natural substrates labelled with 11C, 13N, or 15O. Myocardial metabolism is complex and utilizes a number of substrates, primarily fatty acids. Fatty acids utilization can be studied with 11C palmitate, while 11C acetate more selectively traces TCA cycle activity and reflects myocardial oxygen utilization. Glucose uptake can be traced using 18F deoxyglucose, a glucose analog that is a substrate for hexokinase but is not further metabolized. Flow and oxidative glucose metabolism are usually coupled, and thereby the uptake of FDG and perfusion tracers are usually similar. In myocardial ischemia, however, glucose utilization can persist due to anaerobic glycolysis, and its uptake is frequently enhanced. Clinical applications of the use of metabolic studies in patients with ischemic heart disease are presented.

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C-11 labeled palmitic acid for the noninvasive evaluation of regional myocardial fatty acid metabolism with positron-computed tomography

Cited by 142 publications

References 32 publications

Oxidative metabolism in the myocardium in normal subjects during dobutamine infusion

Oxidative metabolism in the myocardium in normal subjects during dobutamine infusion

Myocardial scintigraphy with iodine-123 phenylpentadecanoic acid and thallium-201 in patients with coronary artery disease: a comparative dual-isotope study

Imaging of myocardial metabolism by positron emission tomography

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