PET IN ACUTE MYOCARDIAL INFARCTION

宠物在急性心肌梗死中的应用

• 批准号: 3358506
• 负责人: MARKUS SCHWAIGER
• 金额: $ 36.82万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-08-01 至 1994-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3358506
• 关键词: acute disease /disorder; ammonia; arrhythmia; catecholamines; deoxyglucose; diagnosis design /evaluation; disease /disorder model; dogs; early diagnosis; ephedrine; heart imaging /visualization /scanning; image processing; myocardial infarct sizing; myocardial ischemia /hypoxia; noninvasive diagnosis; positron emission tomography; radiotracer

Acute myocardial infarction is characterized by.heterogeneous tissue injury affecting many aspects of myocardial function. Positron emission tomography (PET) in combination with tracers labeled with short-lived radionuclides allows the in-vivo assessment of specific physiologic and biochemical processes. Such physiologic imaging provide unique tissue characterization in patients with acute myocardial infarction. The extent of ischemic injury can be more accurately assessed than possible with any other non-invasive technique currently available. This proposal will focus on the on the quantitative determination of regional my cardial blood flow, the metabolic differentiation of reversible and irreversible tissue injury and the evaluation of regional catecholamine uptake by adrenergic nerve terminals in patients vith acute myocardial infarction. A new PET approach employing the flow tracer N-13 aumnia in combination with a 3-compartmental tracer kinetic model wi be validated in normal and reperfused canine myocardium using microopheres blood fl. measurements as a gold standard. Metabolic imaging with F-18 deoxyglucose and C-11 ac tate will be used to quantitatively assess oxidative and non-oxidative substrate met bolism by dynamic PET imaging and tracer kineti principles. Animal studies will a dress the value of C-11 acetate kinetics as marker of TCA cycle flux to define tiss viability. Clinically, the metabolic recovery of reperfused human myocardium will characterized and th diagnostic accuracy of the combined evaluation of flow reser and glucose utilization for definition of myor-ardium at risk and extent of necros determined. Finally, the new catecholamine analog C-11 hydroxyephedrine, which traces specifically norepinephrine uptake and storage in adrenergic nerve terminals, will used to relate regional, neuronal function to regiona blood flow and metabolism experimental and clinical myocardial infarction. Correlation of regional neuronal function with the results of electrophysiologic studies will define the potential roll of "neuronal imaging" to identify high risk patients for fatal arrhythmias. The proposed research will provide new insights into substrate metabolism and neuronal function, which is expected to result in new imaging approache for the early assessment of tissue damage, risk stratification and optimization of therapeutic strategies in patients with acute infarction.

急性心肌梗塞的特点是异质组织 损伤影响心肌功能的许多方面。正电子发射 断层扫描 (PET) 与短寿命标记的示踪剂相结合 放射性核素可以对特定的生理和功能进行体内评估 生化过程。 这种生理成像提供了独特的组织 急性心肌梗塞患者的特征分析。程度 可以比任何方法更准确地评估缺血性损伤 目前可用的其他非侵入性技术。 该提案将侧重于定量确定 局部心肌血流、代谢分化可逆 和不可逆组织损伤及局部儿茶酚胺的评价 急性心肌病患者肾上腺素能神经末梢的摄取 梗塞。采用流量示踪剂 N-13 aumnia 的新 PET 方法 与三室示踪剂动力学模型的组合将在 使用微球血液 fl 观察正常和再灌注的犬心肌。 测量作为黄金标准。 F-18 脱氧葡萄糖代谢成像 C-11 ac tate将用于定量评估氧化和 通过动态 PET 成像和示踪动力学进行非氧化底物代谢 原则。动物研究将探讨 C-11 乙酸酯动力学的价值 作为 TCA 循环通量的标记来定义 tiss 活力。临床上， 再灌注人心肌的代谢恢复将被表征和 流量储备和血糖联合评估的诊断准确性 用于定义有风险的心肌和坏死的程度 决定。最后，新的儿茶酚胺类似物C-11羟基麻黄碱， 它专门追踪去甲肾上腺素在肾上腺素能细胞中的吸收和储存 神经末梢，将用于将区域、神经元功能与区域联系起来 血流和代谢实验和临床心肌梗死。 区域神经元功能与结果的相关性 电生理学研究将定义“神经元的潜在滚动” 成像”来识别致命性心律失常的高风险患者。 拟议的研究将为底物代谢提供新的见解 和神经元功能，预计将产生新的成像方法 用于早期评估组织损伤、风险分层和 急性梗死患者治疗策略的优化