Quantitative evaluation of regional substrate metabolism in the human heart by positron emission tomography

R. J. Hicks, W. H. Herman, V. Kalff, E. Molina, E. R. Wolfe, Gary Hutchins, M. Schwaiger

Research output: Contribution to journalArticle

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Abstract

Meaningful interpretation of metabolic images obtained by positron emission tomography for evaluation of cardiac disease requires a knowledge of the normal variation in regional myocardial substrate metabolism. Recent studies with fluorine-18 (F-18) fluorodeoxyglucose suggest inhomogeneity of myocardial glucose metabolism in the normal human heart, which may relate to substrate availability. Therefore, quantitative evaluation of myocardial oxidative metabolism and glucose metabolism, as derived by dynamic positron emission tomography with carbon-11 (C-11) acetate and F-18 fluorodeoxyglucose, was performed in nine healthy male volunteers. All were studied under tightly controlled metabolic conditions of hyperinsulinemic-euglycemic clamping with and without a concurrent lipid emulsion infusion. Significant inhomogeneity of regional glucose metabolism was noted although it was less than that described under fasting conditions. Glucose utilization was 13% lower in the septum compared with the lateral wall both without and with lipid infusion (0.34 vs. 0.39 μmol/g per min, respectively, p <0.05; and 0.33 vs. 0.38 μmol/g per min, respectively, (p <0.05). Relatively decreased septal glucose utilization could not be explained by decreased metabolic demand because C-11 clearance constants were marginally higher in the septum than in the lateral wall in both studies (0.055 vs. 0.054 per min, respectively, p = NS; and 0.061 vs. 0.056 per min, respectively, p <0.05). Relatively decreased septal glucose utilization could reflect regional variation in substrate use and possible preferential free fatty acid utilization by the septum. These data provide a useful framework for assessing altered cardiac metabolism in disease and support standardization of metabolic conditions during metabolic imaging with positron emission tomography.

Original languageEnglish (US)
Pages (from-to)101-111
Number of pages11
JournalJournal of the American College of Cardiology
Volume18
Issue number1
StatePublished - 1991
Externally publishedYes

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Positron-Emission Tomography
Glucose
Fluorodeoxyglucose F18
Lipids
Glucose Clamp Technique
Fluorine
Emulsions
Nonesterified Fatty Acids
Heart Diseases
Fasting
Healthy Volunteers
Acetates
Carbon

ASJC Scopus subject areas

  • Nursing(all)

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Quantitative evaluation of regional substrate metabolism in the human heart by positron emission tomography. / Hicks, R. J.; Herman, W. H.; Kalff, V.; Molina, E.; Wolfe, E. R.; Hutchins, Gary; Schwaiger, M.

In: Journal of the American College of Cardiology, Vol. 18, No. 1, 1991, p. 101-111.

Research output: Contribution to journalArticle

Hicks, R. J. ; Herman, W. H. ; Kalff, V. ; Molina, E. ; Wolfe, E. R. ; Hutchins, Gary ; Schwaiger, M. / Quantitative evaluation of regional substrate metabolism in the human heart by positron emission tomography. In: Journal of the American College of Cardiology. 1991 ; Vol. 18, No. 1. pp. 101-111.
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