Dobutamine-stress electrocardiographically gated positron emission tomography for detection of viable but dysfunctional myocardium

Purpose. This study was performed to determine whether Low-dose dobutamine stress electrocardiography (ECG)-gated fluorine-18 fluorodeoxyglucose (FDG) -positron emission tomography (PET) can assess wall motion and identify myo cardium without contractile reserve despite preserved FDG uptake. Methods. Fifty-three patients with myocardial infarction and normal sinus r hythm underwent EGG-gated FDG-PET and transthoracic echocardiography. Wall motion of 10 segments of the left ventricle was graded as normal, hypokinet ic, or akinetic/dyskinetic, Results, In 365 (76%) of 480 segments, assessment of wall motion was concor dant between the 2 modalities. In 30 patients dobutamine-stress EGG-gated F DG-PET was performed. In 13 (50%) of 26 dysfunctional segments with normal FDG uptake, 16 (36%) of 44 dysfunctional segments with mildly reduced FDG u ptake and 12 (25%) of 48 dysfunctional segments with moderately reduced FDG uptake, wall motion was improved by dobutamine infusion. Conclusion. Assessment of left ventricular wall motion with EGG-gated FDG-P ET is feasible, and dobutamine stress EGG-gated FDG-PET can simultaneously identify metabolic viability and contractile reserve.