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Cardiac 18F-FDG-SPET studies in patients with non-insulin-dependent diabetes mellitus during hyperinsulinaemic euglycaemic clamping. 1997

J J Bax, and F C Visser, and P G Raymakers, and A Van Lingen, and J H Cornel, and J M Huitink, and A Elhendy, and R J Heine, and C A Visser
Department of Cardiology, University Hospital Leiden, The Netherlands.

Identification of viable myocardium is possible with 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET). More recently, the feasibility of cardiac FDG imaging with single photon emission tomography (SPET) has been reported. In patients with diabetes mellitus, poor image quality is frequently obtained with FDG-PET, due to relative or absolute insulin deficiency and peripheral insulin resistance. To improve image quality of the FDG-PET studies, the hyperinsulinaemic glucose clamp has been proposed. We assessed the image quality of cardiac FDG-SPET studies in 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) and compared the results with those obtained in 10 patients without NIDDM. All FDG studies were performed during hyperinsulinaemic glucose clamping. Image quality was expressed as myocardial to blood pool activity (M/B) ratios. Residual viability was assessed in dysfunctional myocardium. The M/B ratios were comparable between patients with and without NIDDM (2.67 +/- 0.8 vs 2.50 +/- 0.7, N.S.). Residual viability was detected in 51% of the dysfunctional segments of the patients with NIDDM and in 49% of the segments of the patients without NIDDM. In the small subset of patients (n = 10) undergoing revascularization, 19 of 20 (95%) segments that had improved wall motion were viable on FDG-SPET. In contrast, 27 of 36 (75%) segments that did not improve were necrotic on FDG-SPET. Thus FDG-SPET during hyperinsulinaemic glucose clamping provides adequate image quality in patients with NIDDM compared with patients without NIDDM, and can be used in the detection of viable myocardium.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D007328 Insulin A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1). Iletin,Insulin A Chain,Insulin B Chain,Insulin, Regular,Novolin,Sodium Insulin,Soluble Insulin,Chain, Insulin B,Insulin, Sodium,Insulin, Soluble,Regular Insulin
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001786 Blood Glucose Glucose in blood. Blood Sugar,Glucose, Blood,Sugar, Blood
D003327 Coronary Disease An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. Coronary Heart Disease,Coronary Diseases,Coronary Heart Diseases,Disease, Coronary,Disease, Coronary Heart,Diseases, Coronary,Diseases, Coronary Heart,Heart Disease, Coronary,Heart Diseases, Coronary
D003847 Deoxyglucose 2-Deoxy-D-arabino-hexose. An antimetabolite of glucose with antiviral activity. 2-Deoxy-D-glucose,2-Deoxyglucose,2-Desoxy-D-glucose,2 Deoxy D glucose,2 Deoxyglucose,2 Desoxy D glucose
D003924 Diabetes Mellitus, Type 2 A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY. Diabetes Mellitus, Adult-Onset,Diabetes Mellitus, Ketosis-Resistant,Diabetes Mellitus, Maturity-Onset,Diabetes Mellitus, Non-Insulin-Dependent,Diabetes Mellitus, Slow-Onset,Diabetes Mellitus, Stable,MODY,Maturity-Onset Diabetes Mellitus,NIDDM,Diabetes Mellitus, Non Insulin Dependent,Diabetes Mellitus, Noninsulin Dependent,Diabetes Mellitus, Noninsulin-Dependent,Diabetes Mellitus, Type II,Maturity-Onset Diabetes,Noninsulin-Dependent Diabetes Mellitus,Type 2 Diabetes,Type 2 Diabetes Mellitus,Adult-Onset Diabetes Mellitus,Diabetes Mellitus, Adult Onset,Diabetes Mellitus, Ketosis Resistant,Diabetes Mellitus, Maturity Onset,Diabetes Mellitus, Slow Onset,Diabetes, Maturity-Onset,Diabetes, Type 2,Ketosis-Resistant Diabetes Mellitus,Maturity Onset Diabetes,Maturity Onset Diabetes Mellitus,Non-Insulin-Dependent Diabetes Mellitus,Noninsulin Dependent Diabetes Mellitus,Slow-Onset Diabetes Mellitus,Stable Diabetes Mellitus
D003925 Diabetic Angiopathies VASCULAR DISEASES that are associated with DIABETES MELLITUS. Diabetic Vascular Complications,Diabetic Vascular Diseases,Microangiopathy, Diabetic,Angiopathies, Diabetic,Angiopathy, Diabetic,Diabetic Angiopathy,Diabetic Microangiopathies,Diabetic Microangiopathy,Diabetic Vascular Complication,Diabetic Vascular Disease,Microangiopathies, Diabetic,Vascular Complication, Diabetic,Vascular Complications, Diabetic,Vascular Disease, Diabetic,Vascular Diseases, Diabetic
D004452 Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Echocardiography, Contrast,Echocardiography, Cross-Sectional,Echocardiography, M-Mode,Echocardiography, Transthoracic,Echocardiography, Two-Dimensional,Transthoracic Echocardiography,2-D Echocardiography,2D Echocardiography,Contrast Echocardiography,Cross-Sectional Echocardiography,Echocardiography, 2-D,Echocardiography, 2D,M-Mode Echocardiography,Two-Dimensional Echocardiography,2 D Echocardiography,Cross Sectional Echocardiography,Echocardiography, 2 D,Echocardiography, Cross Sectional,Echocardiography, M Mode,Echocardiography, Two Dimensional,M Mode Echocardiography,Two Dimensional Echocardiography

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