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Characterization of a highly effective preparation for suppression of myocardial glucose utilization.

ABSTRACT:

Background

With appropriate protocols, F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can visualize myocardial inflammation. Optimal protocols and normative myocardial FDG uptake values are not well-established.

Methods

We evaluated 111 patients referred for inflammation cardiac FDG PET/CT. Patients followed a low-carbohydrate, high-fat diet for 36 hours before imaging and received unfractionated heparin. Glucose and fatty acid metabolism biomarkers were obtained. Mean blood pool and maximum myocardial uptake (SUV_mean, SUV_max) were measured, avoiding areas of abnormal FDG uptake or spillover.

Results

Adequate suppression of myocardial FDG uptake occurred in 95% of patients (n = 106). Myocardial SUV_max was significantly below background blood pool SUV_mean: septal myocardial to blood pool ratio 0.75 (95% CI 0.73-0.77; P < 0.001); lateral myocardial to blood pool ratio 0.70 (95% CI 0.68-0.72; P < 0.001). Glucose, insulin, and C-peptide correlated to blood pool SUV_mean (Spearman r_s = 0.39, P < 0.01; r_s = 0.40, P < 0.01; r_s = 0.35, P < 0.01) and myocardial SUV_max (Spearman r_s = 0.31, P < 0.01; r_s = 0.31, P < 0.01; r_s = 0.26, P < 0.01). Fatty acid metabolism biomarkers did not correlate to myocardial SUV_max.

Conclusions

Patients following intensive metabolic preparation have myocardial FDG SUV_max below background SUV_mean. Biomarkers of glucose metabolism modestly correlate to FDG uptake.

SUBMITTER: Larson SR

PROVIDER: S-EPMC6928445 | biostudies-literature |

REPOSITORIES: biostudies-literature

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