HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 287/5/H2226    most recent 00263.2004v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Mazzadi, A. N. Articles by Croisille, P. Search for Related Content PubMed PubMed Citation Articles by Mazzadi, A. N. Articles by Croisille, P.

Tagged MRI and PET in severe CAD: discrepancy between preoperative inotropic reserve and intramyocardial functional outcome after revascularization

¹Centre de Recherche et d'Applications en Traitement de l'Image et du Signal, Unité Mixed de Recherche-Centre National de Recherche Scientifique 5515, Unité 630, Institut National de la Santé et de la Recherche Médicale, 69394 Lyon; ²Centre d'Exploration et de Recherche Médicales par Émission de Positons, 69003 Lyon; ³Université Claude Bernard Lyon I, 69008 Lyon; and ⁴Hôpital Cardio-Vasculaire et Pneumologique Louis Pradel, 69677 Bron Cedex, Lyon, France

Submitted 16 March 2004 ; accepted in final form 28 June 2004

In severe coronary artery disease (CAD), it has been shown that intramyocardial inotropic reserve as assessed with tagged magnetic resonance imaging (MRI) is uniformly distributed among positron emission tomography (PET) patterns reflecting normal or concomitant reductions in perfusion and glucose metabolism. This preliminary study aimed to delineate the relationship between preoperative values of intramyocardial inotropic reserve (in different PET patterns of perfusion and glucose uptake) and intramyocardial functional outcome after surgical revascularization in severe CAD. Twelve patients underwent preoperative tagged MRI (baseline, 10 µg·kg^–1·min^–1 of dobutamine), H₂¹⁵O/[¹⁸F]fluorodeoxyglucose PET imaging, and postoperative resting tagged MRI. Regional midmyocardial circumferential shortening (E_cc, in %) and PET patterns (normal, match viable, mismatch viable, and infarcted) were assessed in three tagged MRI/PET short-axis slices. E_cc at baseline ranged from 12 ± 6 to 8 ± 5 and 4 ± 4% in normal, match-viable, and infarcted regions, respectively (P < 0.05) and was 8 ± 5% in mismatch-viable regions. Of the 429 regions studied, 187 showed preoperative inotropic reserve with dobutamine, but 238 showed postoperative functional improvement. Postoperative functional improvement was less common in infarcted regions (41 vs. 60% in the other PET patterns), but the extent of improvement was similar among PET patterns (6%). Postoperative functional improvement occurred in 53% of all (normal, match viable, and mismatch viable) regions without inotropic reserve. In severe CAD, revascularization affords greater intramyocardial functional benefit than expected from the evaluation of intramyocardial inotropic reserve with low-dose dobutamine. Postoperative functional improvement in PET-viable regions without inotropic reserve suggests that factors other than regionally enhanced perfusion contribute to such functional improvement.

magnetic resonance imaging; positron emission tomography; dobutamine; myocardial viability

This article has been cited by other articles:

				A. N. Mazzadi, X. Andre-Fouet, N. Costes, P. Croisille, D. Revel, and M. F. Janier Mechanisms leading to reversible mechanical dysfunction in severe CAD: alternatives to myocardial stunning Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2570 - H2582. [Abstract] [Full Text] [PDF]