SUPERIORITY OF C-11 ACETATE COMPARED WITH F-18 FLUORODEOXYGLUCOSE IN PREDICTING MYOCARDIAL FUNCTIONAL RECOVERY BY POSITRON EMISSION TOMOGRAPHY IN PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION

In patients with chronic coronary artery disease, preservation of myoc ardial oxidative metabolism measured by positron emission tomography ( PET) with C-11-acetate is a more accurate predictor of subsequent myoc ardial functional recovery than is maintenance of glucose metabolism e stimated with F-18-fluorodeoxyglucose. However, whether measurements o f myocardial oxidative metabolism ore more accurate than measurements of glucose metabolism in predicting functional recovery in patients wi th recent myocardial infarction is unknown. Myocardial oxidative metab olism was measured within 10 days of infarction in 19 patients by anal ysis of the rate of myocardial clearance of C-11-ocetate. Metabolism o f glucose was assessed by analysis of the uptake of F-18-fluorodeoxygl ucose. Criteria for prediction of the recovery of function based on me asurements of oxidative metabolism and glucose metabolism were compare d. Threshold criteria with C-11-acetate exhibited superior positive an d negative predictive values (89% and 73%, respectively) compared with the criteria of F-18-fluorodeoxyglucose (65% and 57%, respectively) ( p <0.025). In addition, the magnitude of functional recovery after rev ascularization correlated with the severity of the metabolic abnormali ty present initially. In patients with recent myocardial infarction, t he extent of functional recovery can be predicted accurately by measur ement of regional oxidative metabolism by PET with C-11-acetate, and t hese measurements ore superior to those of (18)-fluorodeoxyglucose. (C ) 1996 by Excerpta Medica, Inc.