Metabolic Responses of Hibernating and Infarcted Myocardium To Revascularization - a Follow-up-study of Regional Perfusion, Function, and Metabolism
(1992) Circulation — Vol. 85, n° 4, p. 1347-1353 (1992)
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- Background. The presence of persistent myocardial uptake of F-18-deoxyglucose (FDG) within hypoperfused, dysfunctional segments has been shown to predict the recovery of regional contractile function after revascularization. The spectrum of metabolic responses of such hibernating tissue to revascularization is less clear. Methods and Results. Sixteen patients with previous infarction were studied before and after revascularization by myocardial perfusion imaging using Rb-82 positron emission tomography, digitized two-dimensional echocardiography, and imaging of postexercise FDG uptake. Hibernation was identified in 35 of 85 segments showing perfusion and wall motion disturbances before intervention. At follow-up (4.9 +/- 2.6 months after revascularization), hibernating segments were characterized by reduction of wall motion score (p < 0.001), improvement of perfusion (p < 0.001), and reduction of FDG activity (p < 0.001). Of the 35 hibernating segments, however, 10 still had abnormal elevation of FDG uptake (> 2 SD above normal) without differing from other hibernating segments with respect to postoperative perfusion or wall motion score. Segments with persistently abnormal metabolism were characterized before intervention by more severe malperfusion (p < 0.01) and greater FDG activity (p < 0.01). Conclusions. Although wall motion and perfusion improve with revascularization of hibernating tissue, myocardial metabolism remains abnormal in a significant proportion of segments. These segments are characterized by more extensive perfusion and metabolic changes before revascularization.
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Marwick, TH., Macintyre, WJ., Lafont, A., Nemec, JJ., & Salcedo, EE. (1992). Metabolic Responses of Hibernating and Infarcted Myocardium To Revascularization - a Follow-up-study of Regional Perfusion, Function, and Metabolism. Circulation, 85(4), 1347-1353. https://hdl.handle.net/2078.5/44690 (Original work published 1992)