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Effects of substrate availability on myocardial C-11 palmitate kinetics by positron emission tomography in normal subjects and patients with ventricular dysfunction

The American heart journal, 1986-06, Vol.111 (6), p.1055-1064 [Peer Reviewed Journal]

1986 ;1986 INIST-CNRS ;ISSN: 0002-8703 ;EISSN: 1097-6744 ;DOI: 10.1016/0002-8703(86)90006-2 ;PMID: 3487240 ;CODEN: AHJOA2

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  • Title:
    Effects of substrate availability on myocardial C-11 palmitate kinetics by positron emission tomography in normal subjects and patients with ventricular dysfunction
  • Author: Schelbert, Heinrich R. ; Henze, Eberhard ; Sochor, Heinz ; Grossman, Robert G. ; Huang, Sung-Cheng ; Barrio, Jorge R. ; Schwaiger, Markus ; Phelps, Michael E.
  • Subjects: Adult ; Biological and medical sciences ; Blood Glucose - metabolism ; Carbon Radioisotopes ; Cardiology. Vascular system ; Fatty Acids, Nonesterified - blood ; Female ; Heart ; Heart Diseases - metabolism ; Heart Diseases - physiopathology ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Hemodynamics ; Humans ; Kinetics ; Male ; Medical sciences ; Metabolic Clearance Rate ; Middle Aged ; Myocardium - metabolism ; Palmitates - metabolism ; Palmitic Acids - metabolism ; Tomography, Emission-Computed
  • Is Part Of: The American heart journal, 1986-06, Vol.111 (6), p.1055-1064
  • Description: The possibility of demonstrating noninvasively with C-11 palmitate and positron emission tomography (PET) changes in myocardial substrate metabolism in normal and diseased human myocardium in response to altered substrate availability in blood and disease-related abnormalities was examined in five normal volunteers and 16 patients with ventricular dysfunction. C-11 palmitate injection and serial PET imaging were performed after an overnight fast (control period) and again 2 hours later after oral glucose (50 gm). Myocardial C-11 time-activity curves from serial PET images revealed a biexponential clearance pattern. An early rapid phase, defined by relative size and clearance half-time, reflects C-11 palmitate oxidation and the late slow phase tracer deposition in the endogenous lipid pool. During the control period, the tracer fraction entering the early rapid phase averaged 47 ± 13% (SD) in normal subjects and 45 ± 12% in patients. Corresponding clearance half-times were 19 ± 7 and 20 ± 5 minutes, respectively. Heart rate and blood pressure remained unchanged after glucose, but plasma glucose levels rose by 72.5% in normal subjects and by 98.9% in patients, while free fatty acid levels fell by 72% and 42% ( p < 0.001), respectively. In normal subjects, the tracer fraction in the early rapid phase fell by 43% ( p < 0.005) and the clearance half-time increased by 46% ( p < 0.01). In patients, the response of C-11 palmitate tissue kinetics to glucose was variable. In nine patients, it was similar to that in normal subjects while in the other seven patients a “paradoxic” response occurred. The tracer fraction entering the rapid clearance phase increased after glucose by 30% ( p < 0.05) associated with a 36% ( p < 0.05) decline in clearance half-times. The paradoxic response was unrelated to disease etiology or plasma substrate levels but occurred mostly in left ventricles with more severely depressed function. Thus, PET and C-11 palmitate allow the noninvasive demonstration of the known response of substrate metabolism of the human heart to altered substrate availability. Glucose administration in fasted humans serves as a provocative test of substrate regulation which can be abnormal in myocardial disease and can be demonstrated noninvasively.
  • Publisher: New York, NY: Mosby, Inc
  • Language: English
  • Identifier: ISSN: 0002-8703
    EISSN: 1097-6744
    DOI: 10.1016/0002-8703(86)90006-2
    PMID: 3487240
    CODEN: AHJOA2
  • Source: MEDLINE
    Alma/SFX Local Collection
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