Circulation, Vol 80, 863-872, Copyright © 1989 by American Heart Association
JJ Armbrecht, DB Buxton, RC Brunken, ME Phelps and HR Schelbert
Experimental studies of animals have previously demonstrated the validity
of [1-11C]acetate as a tracer of oxidative metabolism for use with positron
emission tomography. The present study was undertaken to define in normal
human volunteers the relation between myocardial clearance kinetics of
[1-11C]acetate, and the rate-pressure product as an index of myocardial
oxygen consumption. Twenty-two studies were performed of 12 volunteers. The
rate-pressure product was increased with continuous supine bicycle exercise
in six studies. Of the 16 resting studies, seven were performed in the
fasted state and nine following an oral glucose load, to define possible
effects of substrate availability on the tracer-tissue kinetics. Myocardial
tissue time- activity curves were biexponential. Clearance of activity was
homogeneous throughout the myocardium. The rate constants k1, obtained from
biexponential fitting, and kmono, obtained by monoexponential fitting of
the initial linear portion of the time-activity curves, correlated well
with the rate-pressure product. Although the correlation coefficient was
higher for k1 than for kmono (0.95 vs. 0.91), analysis on a sectorial basis
showed less regional variability in kmono. This suggests that kmono, which
is more practical than k1 because it requires shorter acquisition times,
may be more clinically and experimentally useful for detection of
myocardial segments with abnormal oxygen consumption. Overall, changes in
myocardial substrate supply were without significant effect on the relation
between the rate constants (k1 and kmono) and the rate-pressure product,
although a small decrease in kmono/rate-pressure product was observed
following oral glucose by paired analysis in four subjects. It is concluded
that [1-11C]acetate can be used for the noninvasive measurement of
myocardial oxygen consumption in humans with positron emission tomography,
and, thus, has clinical and experimental potential as a tool for the
understanding and diagnosis of myocardial disease.
ARTICLES
Regional myocardial oxygen consumption determined noninvasively in humans with [1-11C]acetate and dynamic positron tomography
Department of Radiological Sciences, UCLA School of Medicine 90024.
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