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Effect of Biventricular Pacing on Myocardial Glucose Metabolism in Patients with Heart Failure Using Fluoro‐18‐Deoxyglucose Positron Emission Tomography
Author(s) -
OHKUSU YASUO,
TAKAHASHI NOBUKAZU,
ISHIKAWA TOSHIYUKI,
SUMITA SHINICHI,
KOBAYASHI TSUKASA,
MATSUSHITA KOHEI,
YAMAKAWA YOUHEI,
UCHINO KAZUAKI,
KIMURA KAZUO,
INOUE TOMIO,
UMEMURA SATOSHI
Publication year - 2003
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2003.00004.x
Subject(s) - medicine , deoxyglucose , heart failure , positron emission tomography , cardiology , carbohydrate metabolism , nuclear medicine
OHKUSU, Y., et al .: Effect of Biventricular Pacing on Myocardial Glucose Metabolism in Patients with Heart Failure Using Fluoro‐18‐Deoxyglucose Positron Emission Tomography.Biventricular pacing has recently been found beneficial in the treatment of congestive heart failure (CHF). Meanwhile, positron emission tomography (PET) has emerged as a new method to analyze glucose metabolism in the heart. Five patients (mean age68.8 ± 8.1 years, 4 men) who received biventricular pacing therapy for5.8 ± 6.6weeks for CHF were studied. Myocardial glucose metabolism was evaluated by PET with fluoro‐18‐deoxyglucose ( 18 F‐FDG), and percent uptake (%uptake) of 18 F‐FDG was calculated during biventricular pacing and compared with that during 1 hour of conventional RV pacing. Biventricular pacing was associated with a significant decrease in NYHA functional Class from 3.67 ± 0.52 to 2.50 ± 0.55. After 18 F‐FDG PET, three of five patients remained clinically stable, and two died during follow‐up. Mean 18 F‐FDG %uptake during biventricular pacing was not different than during short‐term RV pacing (62.1 ± 18.4vs.63.6 ± 17.0%). However, patients who remained clinically stable had a lower value of 18 F‐FDG %uptake in the septal region than patients who died (46.9 ± 5.6vs80.3 ± 1.3%, P < 0.01). One patient whose cardiac function improved significantly also had a small septal region of decreased 18 F‐FDG uptake during RV pacing. In conclusion, biventricular pacing therapy was effective in this small group of patients with severe, drug‐resistant CHF. An evaluation of the effects of biventricular pacing on glucose metabolism in the subacute phase may help identify patients with a favorable long‐term response to this therapy. (PACE 2003; 26[Pt. II]:144–147)