Positron emission tomography using F-18-fluoro-deoxyglucose and euglycaemic hyperinsulinaemic glucose clamp: optimal criteria for the prediction of recovery of post-ischaemic left ventricular dysfunction - Results from the European Community Concerted Action Multicenter study on use of F-18-fluoro-deoxyglucose Positron Emission Tomography for the Detection of Myocardial Viability

Autor: Jacques Melin, Paolo G. Camici, Anne Bol, P. K. Blanksma, Bernhard Gerber, Marc Janier, M. J. Knuuti, Pierre Melon, Jean-Louis Vanoverschelde, J. J. Bax, F. Ordoubadi, William Wijns
Přispěvatelé: Gerber, Bl, Ordoubadi, Ff, Wijns, W, Vanoverschelde, Jlj, Knuuti, Mj, Janier, M, Melon, P, Blanksma, Pk, Bol, A, Bax, Jj, Melin, Ja, Camici, Paolo
Rok vydání: 2001
Předmět:
Blood Glucose
Male
positron emission tomography
medicine.medical_treatment
Coronary Disease
FDG-Positron Emission Tomography
Coronary artery disease
VIABLE MYOCARDIUM
Ventricular Dysfunction
Left
Belgium
London
Myocardial Revascularization
Medicine
Prospective Studies
Finland
Netherlands
F-8-fluoro-2-deoxyglucose
Ejection fraction
medicine.diagnostic_test
F-18 DEOXYGLUCOSE
Middle Aged
INSULIN
Positron emission tomography
HEART-FAILURE
Female
REVASCULARIZATION
France
FUNCTIONAL RECOVERY
Cardiology and Cardiovascular Medicine
coronary artery disease
Tomography
Emission-Computed
Cardiac function curve
Adult
myocardial viability
Revascularization
EJECTION FRACTION
Fluorodeoxyglucose F18
Predictive Value of Tests
Hyperinsulinism
Preoperative Care
Humans
Aged
Ischemic cardiomyopathy
BLOOD-FLOW
business.industry
Myocardium
ISCHEMIC CARDIOMYOPATHY
euglycaemic hyperinsulinaemic glucose clamp
Stroke Volume
Recovery of Function
medicine.disease
CORONARY-ARTERY DISEASE
Heart failure
Glucose Clamp Technique
business
Nuclear medicine
Follow-Up Studies
Zdroj: European Heart Journal, 22(18), 1691-1701. Oxford University Press
ISSN: 0195-668X
Popis: Aims To assess the accuracy of positron emission tomography to predict recovery of global cardiac function after revascularization in patients with coronary artery disease.Methods and Results One hundred and seventy-eight patients (157 male, 58 +/- 10 years) with coronary artery disease and left ventricular dysfunction (mean ejection fraction 39 +/- 14%) were enrolled in six European centres. They underwent a common protocol for the assessment of viability using F-18-fluoro-2-deoxyglucose (FDG) positron emission tomography during a standardized euglycaemic hyperinsulinaemic glucose clamp before revascularization by either surgery (n = 140) or angioplasty (n = 38). Seven patients were excluded because of incomplete revascularization of a dysfunctional region. Based on the recovery of global ejection fraction 2-6 months after revascularization, patients were classified into two groups: 82 patients who had a >5% improvement in ejection fraction postoperatively, and 89 patients without postoperative ejection fraction improvement. Optimal cut-off points for postoperative improvement of global cardiac function were computed, using receiver operating curve analysis. The highest sensitivity (79%) and specificity (55%) for predicting postoperative ejection fraction improvement by positron emission tomography was found when three or more dysfunctional segments had a relative FDG uptake >45% of normal remote myocardium (overall accuracy 67%).Conclusions In a large cohort of coronary patients with impaired ejection fraction, FDG positron emission tomography demonstrated high sensitivity and moderate specificity to predict improvement of cardiac function after coronary revascularization.
Databáze: OpenAIRE
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