Multifocal, persistent cardiac uptake of [18-F]-fluoro-deoxy-glucose detected by positron emission tomography in patients with acute myocardial infarction |
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Authors: | Cosmo Godino Cristina Messa Luigi Gianolli Claudio Landoni Alberto Margonato Michela Cera Coli Stefano Domenico Cianflone Ferruccio Fazio Attilio Maseri |
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Affiliation: | Cardio-Thoracic and Vascular Department of San Raffaele Scientific Institute, Milan, Italy. cosmogodino@gmail.com |
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Abstract: | BACKGROUND: Inflammation appears to be important in the pathogenesis of acute myocardial infarction (AMI). METHODS AND RESULTS: Cardiac [18-F]-fluoro-deoxy-glucose (FDG) uptake by positron emission tomography/computed tomography (PET/CT)-scan was investigated in 12 fasting patients with first AMI (FAMI) single-vessel disease after successful primary percutaneous coronary intervention and at 9 weeks follow-up, and in 12 controls. The average FDG uptake (aFDGu) of the 28 left ventricular (LV) wall segments defined on the PET/CT images of the 12 FAMI patients was 1.28+/-0.57-fold higher than the activity present in the LV cavity. By contrast, the aFDGu of the 12 controls was 0.70+/-22 (p<0.001). The segmental aFDGu in the FAMI was multifocal in both the culprit and non-culprit segments; it was less than LV cavity activity in 38%, 1-2-fold greater in 51.8% and more than 2-fold greater in 10.2%. At follow-up, aFDGu was significantly increased in both culprit and non-culprit segments (1.69+/-1.15, p<0.001). Statistically significant differences between FAMI and controls patients were only found for interleukin-6 plasma levels on admission (11.3+/-7.7 pg/ml vs 2.2+/-1.3 pg/ml; p<0.004). CONCLUSION: Multifocal, non-infarct related, cardiac-FDG-uptake occurred immediately after AMI and persisted at follow-up. The cause of these striking and consistent findings is still speculative. |
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