Abstract
The outcome of acute myocardial infarction has been significantly changed by the introduction of invasive coronary reperfusion procedures. However, the myocardial saving effect of reperfusion is difficult to evaluate in the early phase because of the presence of stunned myocardium. Is it possible to predict the future recovery of regional wall motion early after reperfusion? We assessed regional myocardial glucose metabolism in relation to the late effect of reperfusion. In a dog reperfusion model, there was a good linear correlation between the regional myocardial metabolic rate of glucose (MMRG) determined 12 hours after the termination of reperfusion using 18-F fluorodeoxyglucose (FDG) and positron emission tomography and the amount of surviving myocardium (r=0.86, p<0.01). The MMRG was normal or increased in the area where regional contraction was regained 4 weeks after reperfusion, but was decreased in the area which remained akinetic or dyskinetic in the late phase. When the normal lower limit was set as the mean minus 2 standard deviations in the control group, normal MMRG indicated viable myocardium and later functional recovery, while lower MMRG suggested permanent functional loss. Thus, myocardial viability seems to be appropriately evaluated by the determination of MMRG.
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