Low-carbohydrate diet versus euglycemic hyperinsulinemic clamp for the assessment of myocardial viability with 18F-fluorodeoxyglucose-PET: a pilot study

Soares, José; Filho, Filadelfo Rodrigues; Izaki, Marisa; Giorgi, Maria Clementina Pinto; Catapirra, Rosa M. A.; Abe, Rubens; Vinagre, C.G.; Cerri, Giovanni Guido; Meneghetti, José Cláudio

doi:10.1007/s10554-013-0324-5

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…This technique is however time demanding and can cause clinical problems related to hypoglycemia. Soares et al [19] evaluated a new technique for metabolic preparation which consist of a 24 h low-carbohydrate diet before 18F-FDG imaging. In this pilot study, 30 patients with previous myocardial infarction underwent resting 99Tc Sestamibi SPECT and two 18F-FDG PET studies: one using the clamp technique for metabolic preparation and one using the diet technique.…”

Section: Low-carbohydrate Diet For Myocardial Viability 18f-fdg Pet Imentioning

confidence: 99%

“…Another clinical study investigated the difference of coronary artery disease (CAD) severity and extent as well as plaque characteristics in 1161 patients with hypertension (HT), diabetes mellitus (DM) or dyslipidemia (DL) [67]. Obstructive CAD was most frequent in DM patients, followed by HT and DL patients (34,19 and 15 %, respectively, p \ 0.0001). DM patients had more extensive disease than HT and DL patients.…”

Section: Computed Tomography Componentmentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

Bezerra¹,

Costa²,

Reiber³

et al. 2015

Int J Cardiovasc Imaging

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Section: Low-carbohydrate Diet For Myocardial Viability 18f-fdg Pet Imentioning

confidence: 99%

Section: Computed Tomography Componentmentioning

confidence: 99%

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

Bezerra¹,

Costa²,

Reiber³

et al. 2015

Int J Cardiovasc Imaging

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“…For most studies using [ 18 F]FDG, elevated insulin levels are essential, attained either by glucose loading (oral glucose administration) or by direct insulin administration (e.g., via an insulin clamp procedure). Acipimox, a nicotinic acid derivate, may be an alternative to clamping [ 7 ]. Acipimox inhibits peripheral lipolysis and therefore reduces plasma free-fatty acid levels, and, indirectly, stimulates cardiac [ 18 F]FDG uptake [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

PET/CT Imaging and Physiology of Mice on High Protein Diet

Sijbesma

Waarde

Stegger

et al. 2021

IJMS

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Background: High protein (HP) diets have been proposed to reduce body weight in humans. The diets are known to alter energy metabolism, which can affect the quality of [18F]FDG PET heart images. In this preclinical study, we therefore explore the impact of a prolonged HP diet on myocardial [18F]FDG uptake. Methods: C57BL/6J (Black six (Bl6)) and apolipoprotein E-deficient (apoE−/−) mice were fed chow, a HP diet, or a low protein (LP) diet for 12 weeks. At baseline and after treatment, the animals were injected with 33.0 MBq of [18F]FDG and a 30 min PET/CT scan was made. Myocardial volume and [18F]FDG uptake were quantified using PET and the % of body fat was calculated from CT. Results: Myocardial [18F]FDG uptake was similar for all diets at the follow-up scan but an increase between baseline and follow-up scans was noticed in the LP groups. Myocardial volume was significantly smaller in the C57BL HP group compared to the other Bl6 groups. Body weight increased less in the two HP groups compared to the chow and LP groups. Body fat percentage was significantly higher in the LP groups. This effect was stronger in C57BL mice (28.7%) compared to apoE−/− mice (15.1%). Conclusions: Myocardial uptake of [18F]FDG in mice is not affected by increased protein intake but [18F]FDG uptake increases when the amount of protein is lowered. A lower body weight and percentage of body fat were noticed when applying a HP diet.

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“…Various protocols have been utilized to increase 18 F-FDG uptake in the hibernating myocardium including fasting, oral glucose loading, low-carbohydrate diet, intravenous (IV) or oral glucose and IV insulin loading, acimipox administration to reduce myocardial fatty acid metabolism, and euglycemic hyperinsulinemic clamp. [1][2][3][4][5][6][7] Although euglycemic hyperinsulinemic clamp is considered as the best way to improve 18 F-FDG uptake in the hibernating myocardium, in routine practice oral glucose and IV insulin loading is commonly adopted. [1,4,8] The goal is to provide euglycemia and hyperinsulinemia at the time of 18 F-FDG injection as insulin increases glucose uptake in ischemic Assessing oral glucose and intravenous insulin loading protocol in 18 tissues.…”

Section: Introductionmentioning

confidence: 99%

Assessing oral glucose and intravenous insulin loading protocol in 18F-fluorodeoxyglucose positron emission tomography cardiac viability studies

Sarıkaya¹,

Sarıkaya²,

Elgazzar³

2020

World J Nucl Med

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Oral glucose and intravenous insulin (G/I) loading protocols are commonly used in 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) cardiac viability studies. Although the amount of insulin to be given per blood glucose range has been well described in guidelines, the amount of glucose to be given is not detailed well. In this retrospective study, we aimed to assess if certain parameters, particularly the amount of glucose and insulin given, may affect 18F-FDG uptake in the hibernating myocardium and also determine the problems with this protocol. 18F-FDG PET cardiac viability study with G/I loading protocols was performed in 49 patients. Fasting blood glucose (FBG), amount of glucose given, blood glucose level after glucose load, amount of insulin given, and blood glucose level at the time of 18F-FDG injection were recorded. Statistical analysis was performed to determine if there is any difference in the above values in PET viable and PET nonviable groups and also in subgroups assessing 18F-FDG uptake also in normal myocardium. For G/I loading, we used our local protocol in 43 patients, and other protocols in six. 18F-FDG PET showed viability in 31 patients, and it was negative for viability in 18. In 22 patients, mainly in PET viable group, there was varying degree of reduced 18F-FDG uptake in normal myocardium. There was no significant difference in FBG, amount of glucose given, blood glucose level after glucose load, amount of insulin given, and blood glucose level at the time of 18F-FDG injection in PET viable and PET nonviable groups and also in subgroups. The problems with G/I loading protocol included deciding on the amounts of glucose and insulin given, maximum amount of insulin to be given, handling diabetics, optimal time to measure blood glucose after insulin administration, and interpretation of findings in cases with diffusely reduced 18F-FDG uptake. Further improvements in current guidelines are necessary to obtain images in optimal conditions for accurate results.

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Low-carbohydrate diet versus euglycemic hyperinsulinemic clamp for the assessment of myocardial viability with 18F-fluorodeoxyglucose-PET: a pilot study

Cited by 8 publications

References 39 publications

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

PET/CT Imaging and Physiology of Mice on High Protein Diet

Assessing oral glucose and intravenous insulin loading protocol in 18F-fluorodeoxyglucose positron emission tomography cardiac viability studies

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