Multifocal, persistent cardiac uptake of [18-F]-fluoro-deoxy-glucose detected by positron emission tomography in patients with acute myocardial infarction

Background Inflammation appears to be important in the pathogenesis of acute myocardial infarction (AMI). Methods and Results Cardiac [18-F]-fluoro-deoxy-glucose (FDG) uptake by positron emission tomography/ computed tomography (PET/CT)-scan was investigated in 12 fasting patients with first AMI (FAMI) single-vessel disease after successful primary percutaneous coronary intervention and at 9 weeks follow-up, and in 12 controls. The average FDG uptake (aFDGu) of the 28 left ventricular (LV) wall segments defined on the PET/CT images of the 12 FAMI patients was 1.28 +/- 0.57-fold higher than the activity present in the LV cavity. By contrast, the aFDGu of the 12 controls was 0.70 +/- 22 (p < 0.001). The segmental aFDGu in the FAMI was multifocal in both the culprit and non-culprit segments; it was less than LV cavity activity in 38%, 1-2-fold greater in 5 1.8% and more than 2-fold greater in 10.2%. At follow-up, aFDGu was significantly increased in both culprit and non-culprit segments (1.69 +/- 1.15, p < 0.001). Statistically significant differences between FAMI and controls patients were only found for interleukin-6 plasma levels on admission (11.3 +/- 7.7 pg/ml vs 2.2 +/- 1.3 pg/ml; p < 0.004). Conclusion Multifocal, non-infarct related, cardiac-FDG-uptake occurred immediately after AMI and persisted at follow-up. The cause of these striking and consistent findings is still speculative. (Circ J 2008; 72: 1821-1828)