使用[18F]氟-6-硫代十七烷酸和[18F]氟脱氧葡萄糖正电子发射断层显像（PET）评估充血性心力衰竭患者的心肌脂肪酸和葡萄糖摄取情况。

An evaluation of myocardial fatty acid and glucose uptake using PET with [18F]fluoro-6-thia-heptadecanoic acid and [18F]FDG in Patients with Congestive Heart Failure.

作者信息

Taylor M, Wallhaus T R, Degrado T R, Russell D C, Stanko P, Nickles R J, Stone C K

机构信息

William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.

出版信息

J Nucl Med. 2001 Jan;42(1):55-62.

PMID:11197981

Abstract

UNLABELLED

Understanding the metabolic consequences of heart failure is important in evaluating potential mechanisms for disease progression and assessing targets for therapies designed to improve myocardial metabolism in patients with heart failure. PET is uniquely suited to noninvasively evaluate myocardial metabolism. In this study, we investigated the kinetics of 14(R,S)-[18F]fluoro-6-thia-heptadecanoic acid (FTHA) and [18F]FDG in patients with stable New York Heart Association functional class III congestive heart failure and a left ventricular ejection fraction of no more than 35%.

METHODS

Twelve fasting patients underwent dynamic PET studies using [18F]FTHA and FDG. From the dynamic image data, the fractional uptake rates (Ki) were determined for [18F]FTHA and FDG. Subsequently, serum free fatty acid and glucose concentrations were used to calculate the myocardial free fatty acid and glucose uptake rates, respectively. Uptake rates were compared with reported values for [18F]FTHA and FDG in subjects with normal left ventricular function.

RESULTS

The average Ki for [18F]FTHA was 19.7 +/- 9.3 mL/100 g/min (range, 7.2-36.0 ml/100 g/min). The average myocardial fatty acid use was 19.3 +/- 2.3 mmol/100 g/min. The average Ki for FDG was 1.5 +/- 0.37 mL/100 g/min (range, 0.1-3.3 mL/100 g/min), and the average myocardial glucose use was 12.3 +/- 2.3 mmol/100 g/min.

CONCLUSION

Myocardial free fatty acid and glucose use in heart failure can be quantitatively assessed using PET with [18F]FTHA and FDG. Myocardial fatty acid uptake rates in heart failure are higher than expected for the normal heart, whereas myocardial glucose uptake rates are lower. This shift in myocardial substrate use may be an indication of impaired energy efficiency in the failing heart, providing a target for therapies directed at improving myocardial energy efficiency.

摘要

未标注

了解心力衰竭的代谢后果对于评估疾病进展的潜在机制以及评估旨在改善心力衰竭患者心肌代谢的治疗靶点至关重要。正电子发射断层扫描（PET）特别适合于无创评估心肌代谢。在本研究中，我们调查了14（R，S）-[18F]氟-6-硫代十七烷酸（FTHA）和[18F]氟脱氧葡萄糖（FDG）在纽约心脏协会心功能Ⅲ级稳定型充血性心力衰竭且左心室射血分数不超过35%的患者中的动力学情况。

方法

12名空腹患者接受了使用[18F]FTHA和FDG的动态PET研究。从动态图像数据中，确定了[18F]FTHA和FDG的摄取分数率（Ki）。随后，分别使用血清游离脂肪酸和葡萄糖浓度来计算心肌游离脂肪酸和葡萄糖摄取率。将摄取率与左心室功能正常的受试者中[18F]FTHA和FDG的报告值进行比较。

结果

[18F]FTHA的平均Ki为19.7±9.3 mL/100 g/min（范围为7.2 - 36.0 ml/100 g/min）。平均心肌脂肪酸利用率为19.3±2.3 mmol/100 g/min。FDG的平均Ki为1.5±0.37 mL/100 g/min（范围为0.1 - 3.3 mL/100 g/min），平均心肌葡萄糖利用率为12.3±2.3 mmol/100 g/min。