PT - JOURNAL ARTICLE AU - Abdallah AlMohammad AU - Murdoch Y Norton AU - Andrew E Welch AU - Peter F Sharp AU - Stephen Walton TI - Gated metabolic myocardial imaging, a surrogate for dual perfusion-metabolism imaging by positron emission tomography AID - 10.1136/openhrt-2016-000581 DP - 2017 Jul 01 TA - Open Heart PG - e000581 VI - 4 IP - 2 4099 - http://openheart.bmj.com/content/4/2/e000581.short 4100 - http://openheart.bmj.com/content/4/2/e000581.full SO - Open Heart2017 Jul 01; 4 AB - Objective Perfusion-metabolism mismatch pattern on positron emission tomography (PET) predicts hibernating myocardium. We assess the ECG-gated metabolic PET as a surrogate for the perfusion-metabolism mismatch pattern on PET imaging.Methods 13N-Ammonia (NH3) and 18F-fluorodeoxyglucose (FDG) are respectively perfusion and metabolism PET tracers. We used ECG gating to acquire FDG-PET to collect wall thickening (mechanical) data. These allow detection of metabolic activity in regions with reduced contraction (metabolism-mechanical mismatch pattern). We had two data sets on each patient: perfusion-metabolism and metabolism-mechanical data sets. We tested the hypothesis that metabolism-mechanical pattern on PET could predict perfusion-metabolism mismatch pattern.Results We studied 55 patients (48 males), mean age 62 years. All were in sinus rhythm, and had impaired left ventricular contraction. Perfusion-metabolism mismatch pattern was found in 26 patients. Metabolism-mechanical mismatch pattern was found in 25 patients. The results were concordant in 52 patients (95%). As a surrogate for perfusion-metabolism mismatch pattern, demonstration of metabolism-mechanical mismatch pattern is highly sensitive (92%) and specific (97%). In this cohort, the positive and negative predictive accuracy of the new method are 96% and 93%, respectively.Conclusion Metabolism-mechanical mismatch pattern could predict perfusion-metabolism mismatch pattern in patients with myocardial viability criteria on PET. Prospective validation against the gold standard of improved myocardial contraction after revascularisation is needed.