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The central circulation in heart failure non-invasively evaluated with dynamic positron emission tomography
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
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Article in journal (Refereed) Submitted
URN: urn:nbn:se:uu:diva-92351OAI: oai:DiVA.org:uu-92351DiVA: diva2:165393
Available from: 2004-11-15 Created: 2004-11-15Bibliographically approved
In thesis
1. PET in Heart Failure - Methods and Applications
Open this publication in new window or tab >>PET in Heart Failure - Methods and Applications
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
PET vid hjärtsvikt - metoder och tillämpningar
Abstract [en]

Positron Emission Tomography (PET) permits regional myocardial perfusion, fibrosis and oxidative metabolism to be non-invasively quantified with radioactive tracers such as [15O]-water and [1-11C]-acetate. PET is an established research tool in congestive heart failure (CHF), a major cause of morbidity and mortality. However, as CHF is a syndrome that eventually affects all aspects of cardiac and systemic hemodynamic function, more clinically relevant information from a single PET scan is desirable. The aim of this thesis therefore was to develop and implement some new concepts in cardiac PET.

A new method for the measurement of cardiac output with any tracer was validated in animal experiments and CHF patients. The early pulmonary retention of [1-11C]-acetate was inversely related to left ventricular (LV) function in animals and was directly proportional to lung water content and severity of LV diastolic dysfunction in patients.

Eight patients with acute myocardial infarction were followed with serial PET from 3 hours to 3 weeks after trombolytic treatment. PET revealed that myocardial perfusion and the extraction and utilization of fuel substrates all decreased closer to the infarct centre. The rate of oxygen utilization within the infarct at 3 h predicted degree of myocardial fibrosis, pulmonary oedema and tissue viability at 3 weeks.

Seventeen patients with CHF due to chronic ischemic cardiomyopathy and severely reduced LV function were evaluated with [1-11C]-acetate PET before and after coronary artery bypass surgery. There was a dramatic improvement in physical performance and symptoms, which was not correlated to the standard LV ejection indices. PET revealed that functional improvement was associated with improved LV loading conditions, reversed remodeling and homogenization of oxidative metabolism rather than increased output.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2004. 53 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1387
Medicine, congestive heart failure, myocardial ischemia, positron emission tomography, left ventricular dysfunction, tracer kinetic models, Medicin
National Category
Dermatology and Venereal Diseases
urn:nbn:se:uu:diva-4654 (URN)91-554-6085-2 (ISBN)
Public defence
2004-12-09, Akademiska sjukhuset, Robergsalen, Ingång 40, 4tr, Akademiska Sjukhuset, Uppsala, 13:15
Available from: 2004-11-15 Created: 2004-11-15Bibliographically approved

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