Authors: Lars C GoRMSEn Nana Louise Christensen Elisabeth Bendstrup Lars Poulsen Tolbod Søren Steen Nielsen
Publish Date: 2013/10/17
Volume: 20, Issue: 6, Pages: 1108-1115
Abstract
Cardiac 18Ffluorodeoxyglucose 18FFDG positron emission tomography preceded by extended fasting is used to demonstrate active cardiac sarcoidosis However physiological insulindependent myocardial 18FFDG uptake often obscures 18FFDG uptake in sarcoid lesions We therefore aimed to completely suppress physiological myocardial 18FFDG uptake by pharmaceutically blocking endogenous insulin secretion while elevating free fatty acids FFAsSix patients with suspected cardiac sarcoidosis were studied in a randomized crossover design 1 12 hours fasting followed by 2 hours saline infusion SALINE and 2 12 hours fasting followed by 2 hour infusions of somatostatin 300 μg/hour and heparin 70 mIE/kg/minutes SOMA 18FFDG PET scans were performed postinfusion Glucose insulin and FFA levels were measured and left ventricle SUVvalues were recorded During the SALINE infusion insulin glucose and FFAs remained stable By design the SOMA infusions rapidly 60 minutes suppressed insulin completely while FFA levels peaked at 113 ± 023 mM However SOMA infusions only suppressed cardiac 18FFDG uptake insignificantly globally SUVmean g/mL 40 ± 33 SALINE vs 24 ± 12 SOMA P = 15 and regionally
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