Cho Sang-Geon, Kim Hyung Yoon, Park Ki Seong, Kim Jahae, Moon Jang Bae, Lee Nuri, Park Hyukjin, Cho Jae Yeong, Yoon Hyun Ju, Ahn Youngkeun, Doh Joon-Hyung, Shin Eun-Seok, Kim Kye Hun, Song Ho-Chun
Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
EJNMMI Res. 2025 Sep 2;15(1):116. doi: 10.1186/s13550-025-01311-w.
C-acetate positron emission tomography (PET) enables simultaneous quantification of myocardial blood flow (MBF) and oxidative metabolism; however, sex-specific normative data under vasodilator stress remain insufficiently defined. We aimed to characterize these parameters in healthy individuals.
Eighteen healthy individuals (9 males and 9 females, age/sex-matched; median age 43 years [range 34-65]) with normal echocardiography and no underlying cardiovascular disease underwent one-day rest-stress dynamic C-acetate PET with adenosine. Median stress MBF was 2.73 (2.24-3.11) mL/min/g and rest MBF 0.99 (0.82-1.14) mL/min/g. Stress kmono was 0.074 (0.063-0.082)/min, and rest kmono was 0.061 (0.050-0.068)/min. External cardiac work, total myocardial oxygen consumption (MVO₂), and MEE were 4.24 (3.75-5.54) × 10⁵ mL·mmHg/min, 16.5 (14.9-20.9) mL/min, and 17.7% (14.0-24.2%), respectively. Compared to males, females exhibited significantly higher corrected rest MBF (1.14 vs. 0.96 mL/min/g, p = 0.032), stress kmono (0.078 vs. 0.070 /min, p = 0.005), and total MVO₂ (17.6 vs. 15.5 mL/min, p = 0.003). Despite similar external cardiac work, myocardial external efficiency was significantly lower in females (15.5% vs. 20.3%, p = 0.009). MBF and oxidative metabolism were positively correlated in both sexes.
This study assesses reference ranges and demonstrates significant sex-based differences in myocardial perfusion and oxidative metabolism using vasodilatory stress C-acetate PET. These findings provide a valuable physiological framework for assessing perfusion-metabolism abnormalities in clinical practice.
碳-醋酸盐正电子发射断层扫描（PET）能够同时定量心肌血流量（MBF）和氧化代谢；然而，血管扩张应激下的性别特异性标准数据仍未得到充分界定。我们旨在对健康个体的这些参数进行特征描述。
18名健康个体（9名男性和9名女性，年龄/性别匹配；中位年龄43岁[范围34 - 65岁]），超声心动图正常且无潜在心血管疾病，接受了为期一天的静息-应激动态碳-醋酸盐PET检查，并注射了腺苷。应激状态下的中位MBF为2.73（2.24 - 3.11）mL/min/g，静息状态下的MBF为0.99（0.82 - 1.14）mL/min/g。应激状态下的kmono为0.074（0.063 - 0.082）/min，静息状态下的kmono为0.061（0.050 - 0.068）/min。心脏外部做功、总心肌氧耗（MVO₂）和心肌能量效率（MEE）分别为4.24（3.75 - 5.54）×10⁵ mL·mmHg/min、16.5（14.9 - 20.9）mL/min和17.7%（14.0 - 24.2%）。与男性相比，女性的校正静息MBF显著更高（1.14 vs. 0.96 mL/min/g，p = 0.032）、应激状态下的kmono更高（0.078 vs. 0.070 /min，p = 0.005）以及总MVO₂更高（17.6 vs. 15.5 mL/min，p = 0.003）。尽管心脏外部做功相似，但女性的心肌外部效率显著更低（15.5% vs. 20.3%，p = 0.009）。MBF和氧化代谢在两性中均呈正相关。
本研究评估了参考范围，并通过血管扩张应激碳-醋酸盐PET证明了心肌灌注和氧化代谢存在显著的性别差异。这些发现为临床实践中评估灌注-代谢异常提供了有价值的生理框架。
