Imaging of Myocardial Metabolism

Abstract

Abstract Abnormalities in myocardial substrate metabolism play a key role in the pathogenesis of a host of cardiac disease processes. The importance is highlighted by the routine clinical use of positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) to measure myocardial glucose metabolism to detect viable tissue in patients with ischemic cardiomyopathy and the development of novel therapies designed to modulate myocardial metabolism. Our understanding of myocardial metabolism has benefitted from the application of advanced molecular biologic techniques and the development of elegant genetic models to of myocardial metabolic disease resulting in a greater appreciation for the pleiotropic actions of cellular metabolism. In parallel, there have been significant advances in radionuclide-based metabolic imaging techniques in terms instrumentation design, radiopharmaceutical development and small animal imaging. These advances have further ensconced radionuclide metabolic imaging techniques as tools to further our understanding of various forms of cardiovascular disease and potentially improve the care of the cardiac patient. In this chapter several of key advances in metabolic imaging will be described, their potential new clinical applications are reviewed and contribution to cardiovascular research highlighted.