Hoff S J, Stewart J R, Frist W H, Atkinson J B, Kronenberg M W, Votaw J, Kessler R M, Sandler M P
Department of Cardiac and Thoracic Surgery and Radiology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-5734.
Ann Thorac Surg. 1993 Nov;56(5):1074-7. doi: 10.1016/0003-4975(95)90017-9.
We have shown that positron emission scintigraphy detects changes in the uptake of 18-F 2-deoxyglucose and 13-N ammonia by the acutely rejecting myocardium in a nonworking model of heterotopic heart transplantation in the rat. We developed a new working model of heterotopic heart transplantation to determine the possible relevance of these changes to clinical transplantation. Moderate aortic valvular regurgitation was produced allowing the heterotopic left ventricle to fill and eject. Rejecting allografts and nonrejecting isografts (controls) were studied 4 days after transplantation. Histologically, isografts were normal and all allografts showed mild acute rejection. Decay-corrected uptakes of 18-F 2-deoxyglucose and 13-N ammonia reflect glucose metabolism and blood flow, respectively. Values are presented as percent of injected dose per gram of tissue. Uptake of 18-F 2-deoxyglucose was higher in rejecting allografts compared with nonrejecting isografts (3.0 +/- 1.8 versus 1.1 +/- 0.4; p = 0.024). Ammonia uptake was elevated in allografts compared with isografts (2.2 +/- 0.5 versus 1.3 +/- 0.5; p = 0.023). Uptakes of 18-F 2-deoxyglucose and 13-N ammonia are higher in mildly rejecting allografts, implying increased glucose utilization and blood flow during acute rejection. These data support our earlier findings of changes in myocardial metabolism in the absence of diminishing blood flow in acutely rejecting hearts. This model may lead to a better understanding of the physiology and metabolism of acute rejection.
我们已经表明，在大鼠异位心脏移植的非工作模型中，正电子发射闪烁扫描术可检测到急性排斥反应心肌对18-F 2-脱氧葡萄糖和13-N氨摄取的变化。我们开发了一种新的异位心脏移植工作模型，以确定这些变化与临床移植的可能相关性。制造了中度主动脉瓣反流，使异位左心室能够充盈和射血。在移植后4天研究排斥的同种异体移植物和不排斥的同基因移植物（对照）。组织学上，同基因移植物正常，所有同种异体移植物均显示轻度急性排斥反应。18-F 2-脱氧葡萄糖和13-N氨的衰变校正摄取分别反映葡萄糖代谢和血流。数值表示为每克组织注射剂量的百分比。与不排斥的同基因移植物相比，排斥的同种异体移植物中18-F 2-脱氧葡萄糖的摄取更高（3.0 +/- 1.8对1.1 +/- 0.4；p = 0.024）。与同基因移植物相比，同种异体移植物中氨的摄取增加（2.2 +/- 0.5对1.3 +/- 0.5；p = 0.023）。轻度排斥的同种异体移植物中18-F 2-脱氧葡萄糖和13-N氨的摄取更高，这意味着急性排斥反应期间葡萄糖利用和血流增加。这些数据支持了我们早期的发现，即在急性排斥反应的心脏中，心肌代谢发生变化而血流并未减少。该模型可能有助于更好地理解急性排斥反应的生理学和代谢。
