Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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Evaluation of Non-infarct-Related Arteries Using C-11 Acetate PET in STEMI With Multivessel Disease

  • Sang-Geon Cho (Department of Nuclear Medicine, Chonnam National University Hospital) ;
  • Minchul Kim (Department of Cardiology, Chonnam National University Hospital) ;
  • Seung Hun Lee (Department of Cardiology, Chonnam National University Hospital) ;
  • Ki Seong Park (Department of Nuclear Medicine, Chonnam National University Hospital) ;
  • Jahae Kim (Department of Nuclear Medicine, Chonnam National University Hospital) ;
  • Jang Bae Moon (Department of Nuclear Medicine, Chonnam National University Hospital) ;
  • Ho-Chun Song (Department of Nuclear Medicine, Chonnam National University Hospital)
  • Received : 2021.11.30
  • Accepted : 2022.02.17
  • Published : 2022.07.27
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Abstract

BACKGROUND: We analyzed whether C-11 acetate positron emission tomography (PET) can be used for the evaluation of non-infarct-related artery (NIRA) in patients with ST-elevation myocardial infarction (STEMI) and multivessel disease. METHODS: We prospectively enrolled 31 patients with STEMI and at least one NIRA stenosis (diameter stenosis [DS] ≥ 50%). C-11 acetate PET was performed after successful revascularization for the infarct-related artery (IRA). Myocardial blood flow (MBF) and oxidative metabolism (kmono) were measured and compared between NIRA vs. IRA, stenotic (DS ≥ 50%) vs. non-stenotic (DS < 50%) NIRAs, and NIRAs with significant stenosis (DS ≥ 70% or fractional flow reserve [FFR] ≤ 0.80) vs. those without (neither DS ≥ 70% nor FFR ≤ 0.80). The correlations between PET and angiographic parameters were also analyzed. RESULTS: MBF and kmono were significantly higher in NIRAs than those in IRAs. Stenotic NIRAs showed significantly reduced stress MBF, myocardial flow reserve (MFR), relative flow reserve (RFR) (0.72 ± 0.12 vs. 0.82 ± 0.14; p = 0.001), and stress kmono, as compared to those in non-stenotic NIRAs. NIRAs with significant stenosis had significantly lower stress MBF, MFR, and RFR (0.70 ± 0.10 vs. 0.80 ± 0.14; p = 0.001). RFR showed the best, but modest linear correlation with DS of NIRA stenosis (r = -0.429, p = 0.001). RFR > 0.81 could effectively exclude the presence of significant NIRA stenosis. CONCLUSIONS: C-11 acetate PET could be a feasible alternative noninvasive modality in patients with STEMI and multivessel disease, by excluding the presence of significant NIRA stenosis.

Keywords

Acknowledgement

This research was supported from the Korean Cardiac Research Foundation (Grant No. 201803-02).

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