EFFICACY AND LIMITATION OF F-18 FLUORODEOXYGLUCOSE POSITRON-EMISSION-TOMOGRAPHY DURING FASTING TO ASSESS MYOCARDIAL VIABILITY IN THE ACUTE-PHASE OF MYOCARDIAL-INFARCTION

Objective: The present study was designed to determine the ability of positron emission tomography (PET) to assess myocardial viability and ischemia in acute myocardial infarction (MI) after reperfusion therapy (thrombolysis and/or coronary angioplasty), Methods: PET with fluorin e-18-labeled fluorodeoxyglucose (FDG) under fasting conditions and tha llium-201 single-photon emission computed tomography (TL) were analyze d in 21 patients one week following MI. Myocardial viability was also assessed by regional wall motion using serial analysis of 2-D echocard iography or left ventriculography, Results: Marked uptake of FDG toget her with a residual perfusion defect were observed in the infarct regi on in all patients one week post MI. However, in 9 of the 21 patients, the infarct-related coronary artery had no significant stenosis after reperfusion therapy and remained patent in one month post MI suggesti ng no myocardial ischemia. In contrast, in 4 of the 21 patients the re gional wall motion was akinetic and there was a complete defect observ ed with TL imaging at one month post MI, indicating no viability in th e infarct region. Conclusions: PET using fasting FDG at one week post MI had a limitation to predict myocardial viability or ischemia.