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KMID : 1146220220300030169
Journal of Cardiovascular Imaging
2022 Volume.30 No. 3 p.169 ~ p.180
Evaluation of Non-infarct-Related Arteries Using C-11 Acetate PET in STEMI With Multivessel Disease
Cho Sang-Geon

Kim Min-Chul
Lee Seung-Hun
Park Ki-Seong
Kim Ja-Hae
Moon Jang-Bae
Song Ho-Chun
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] ¡Ã 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 ¡Ã 50%) vs. non-stenotic (DS < 50%) NIRAs, and NIRAs with significant stenosis (DS ¡Ã 70% or fractional flow reserve [FFR] ¡Â 0.80) vs. those without (neither DS ¡Ã 70% nor FFR ¡Â 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 ¡¾ 0.12 vs. 0.82 ¡¾ 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 ¡¾ 0.10 vs. 0.80 ¡¾ 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.
KEYWORD
ST elevation myocardial infarction, Positron emission tomography, Myocardial perfusion imaging, Oxygen consumption
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