Rubin P J, Lee D S, Dávila-Román V G, Geltman E M, Schechtman K B, Bergmann S R, Gropler R J
Division of Nuclear Medicine, Edward Mallinckrodt Institute of Radiology, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Am J Cardiol. 1996 Dec 1;78(11):1230-5. doi: 10.1016/s0002-9149(96)00601-7.
In patients with chronic coronary artery disease, preservation of myocardial oxidative metabolism measured by positron emission tomography (PET) with 11C-acetate is a more accurate predictor of subsequent myocardial functional recovery than is maintenance of glucose metabolism estimated with 18F-fluorodeoxyglucose. However, whether measurements of myocardial oxidative metabolism are more accurate than measurements of glucose metabolism in predicting functional recovery in patients with recent myocardial infarction is unknown. Myocardial oxidative metabolism was measured within 10 days of infarction in 19 patients by analysis of the rate of myocardial clearance of 11C-acetate. Metabolism of glucose was assessed by analysis of the uptake of 18F-fluorodeoxyglucose. Criteria for prediction of the recovery of function based on measurements of oxidative metabolism and glucose metabolism were compared. Threshold criteria with 11C-acetate exhibited superior positive and negative predictive values (89% and 73%, respectively) compared with the criteria of 18F-fluorodeoxyglucose (65% and 57%, respectively) (p <0.025). In addition, the magnitude of functional recovery after revascularization correlated with the severity of the metabolic abnormality present initially. In patients with recent myocardial infarction, the extent of functional recovery can be predicted accurately by measurement of regional oxidative metabolism by PET with 11C-acetate, and these measurements are superior to those of 18-fluorodeoxyglucose.
在慢性冠状动脉疾病患者中，通过正电子发射断层扫描（PET）使用11C-乙酸盐测量的心肌氧化代谢的保留，比使用18F-氟脱氧葡萄糖估计的葡萄糖代谢的维持，更能准确预测随后的心肌功能恢复。然而，在预测近期心肌梗死患者的功能恢复方面，心肌氧化代谢的测量是否比葡萄糖代谢的测量更准确尚不清楚。通过分析11C-乙酸盐的心肌清除率，在19例患者梗死10天内测量了心肌氧化代谢。通过分析18F-氟脱氧葡萄糖的摄取来评估葡萄糖代谢。比较了基于氧化代谢和葡萄糖代谢测量的功能恢复预测标准。与18F-氟脱氧葡萄糖的标准（分别为65%和57%）相比，11C-乙酸盐的阈值标准显示出更高的阳性和阴性预测值（分别为89%和73%）（p<0.025）。此外，血运重建后功能恢复的程度与最初存在的代谢异常的严重程度相关。在近期心肌梗死患者中，通过PET使用11C-乙酸盐测量区域氧化代谢可以准确预测功能恢复的程度，并且这些测量优于18-氟脱氧葡萄糖的测量。
