| Part1Abnormalities of Myocardial Perfusion and Glucose Metabolism in Patients with Isolated Left Ventricular Non-compactionObjective:The aim of the present study was to investigate the myocardial perfusion and glucose metabolism in patients with ILVNC, and the relationships between imaging features and left ventricular ejection fraction (LVEF) were also investigated.Methods:Seventeen ILVNC patients who underwent cardiac magnetic resonance (CMR) and99mTc-sestamibi SPECT/fluorine-18deoxyglucose (18F-FDG) PET imaging were included. Left ventricular non-compaction, regional wall motion abnormalities, left ventricular ejection fraction (LVEF), and delayed enhancement (DE) were estimated using CMR. Myocardial perfusion and metabolism were evaluated with SPECT/PET.Results:Ninety-five (32.9%) segments were considered non-compacted. DE was present in52(18.0%) segments and10(58.8%) patients. The rate of occurrence of DE was significantly higher in compacted segments than in non-compacted segments (22.7%vs8.4%, P=0.003). Myocardial perfusion abnormalities were present in92(31.8%) segments, of which66were perfusion/metabolism match and26were perfusion/metabolism mismatch. The rate of occurrence of perfusion abnormality was similar between compacted and non-compacted segments (32.0%vs31.6%, P=0.948), but it was significantly higher in segments with DE than in those without DE (51.9%vs27.4%, P=0.001). None of the imaging features alone (non-compaction, DE, perfusion abnormalities, match or mismatch) showed significant correlations with LVEF (all P>0.05).Conclusion:In the current study, myocardial perfusion/metabolism mismatch and match were observed in both non-compacted and compacted myocardium in ILVNC patients. Further research is warranted to determine their pathologic and clinical significance. Abstract218F-FDG PET/CT imaging in detection of unstable angina:a pilot study Running title:18F-FDG PET/CT imaging in unstable anginaObjectives:Early recognition of UA is important but difficult especially in stabilized patients recovered from ischemic events. Previous studies have demonstrated that increased myocardial18F-FDG uptake occurs with the onset of ischemia, and may persist even after the restoration of blood flow. This study was aimed to determine the feasibility of18F-FDG positron emission tomography/computed tomography (PET/CT) in detecting unstable angina (UA) patients.Methods:Sixty-one patients (32men and29women, aged58±8years) were prospectively recruited and divided into3groups:UA (n=27), stable angina (n=21), and normal controls (n=13). All patients underwent myocardial18F-FDG PET/CT after an overnight fast. Rest99mTc-sestamibi myocardial perfusion imaging and coronary angiography were also performed.18F-FDG images were firstly evaluated in a visual manner and those with discernible myocardial18F-FDG uptake were further quantitatively analyzed to generate relative uptake value (RUV) of18F-FDG in the3major coronary artery territories. Images with indiscernible18F-FDG uptake were defined as normal and were excluded from the quantitative calculations. Receiver operating characteristic (ROC) curves were plotted to find optimal cut-off values for RUVs. Finally, the diagnostic performance of I8F-FDG imaging was obtained in combination of visual analysis and RUV measurement.Results:Twenty patients had indiscernible18F-FDG uptake whereas the remaining41patients had variable18F-FDG uptake. Higher RUVs were consistently found in the3coronary territories supplied by culprit lesions than by non-culprit lesions (allp<0.05). The sensitivity and specificity of18F-FDG imaging was65.7%and93.9%for the localization of individual culprit vessels, and was70.4%and88.2%for the detection of UA patients.18F-FDG imaging showed higher sensitivity than myocardial perfusion imaging at both patient and vascular level (p<0.05). Furthermore, both sensitivity and specificity of the18F-FDG imaging in detection of UA were not statistically different between diabetes and non-diabetes (all p>0.1). Patients who underwent successful revascularization showed a significant decrease of RUV in ischemic territories.Conclusions:This preliminary study indicates fasting18F-FDG PET/CT imaging has the potential to be used as an accurate technique for the identification of UA.
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