The effects of 18-h fasting with low-carbohydrate diet preparation on suppressed physiological myocardial (18)F-fluorodeoxyglucose (FDG) uptake and possible minimal effects of unfractionated heparin use in patients with suspected cardiac involvement sarcoidosis.
The effects of 18-h fasting with low-carbohydrate diet preparation on suppressed physiological myocardial (18)F-fluorodeoxyglucose (FDG) uptake and possible minimal effects of unfractionated heparin use in patients with suspected cardiac involvement sarcoidosis.
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DOI：
10.1007/s12350-015-0226-0
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发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Tamaki N
中科院分区：
文献类型：
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作者：
Manabe O;Yoshinaga K;Ohira H;Masuda A;Sato T;Tsujino I;Yamada A;Oyama-Manabe N;Hirata K;Nishimura M;Tamaki N
18F-脱氧葡萄糖(FDG)PET在心脏受累结节病(CS)的诊断中具有重要作用。然而，弥漫性左室壁摄取有时使正性摄取和生理性摄取难以区分。本研究的目的是评价低碳水化合物饮食(LCD)禁食18小时和禁食至少6小时对可疑CS患者左心室FDG摄取和游离脂肪酸(FFA)水平的影响。将82例疑似CS患者分为2组，A组禁食6h以上，B组禁食18h，B组禁食18h以上。所有患者在注射FDG前均接受静脉注射普通肝素(UFH；50单位/公斤)。A组左心室弥漫性摄取百分率高于B组(27.6vs0.0%，P=0.0041)。B组游离脂肪酸水平(1159.1 ± 393.0,650.5 ± 310.9μEq/L，P=0.0001)明显高于A组(n=16)，弥漫性左心室摄取患者的游离脂肪酸水平低于其他患者(n=66)(432.1 ± 296.1,888.4 ± 381.4μEq/L，P<0.0001)。UFH治疗显著增加了两组患者的FFAs，即使在弥漫性LV FDG摄取的患者中也是如此。18h禁食可显著降低弥漫性LV摄取，增加FFA水平。特别是，有左室弥漫性摄取的患者的FFA水平显著低于无左室弥漫摄取的患者。通过使用UFH急剧增加血浆FFA可能不会对减少生理性LV FDG摄取有显著作用。
18F-fluorodeoxyglucose (FDG) PET plays an important role in the detection of cardiac involvement sarcoidosis (CS). However, diffuse left ventricle (LV) wall uptake sometimes makes it difficult to distinguish between positive uptake and physiological uptake. The aims of this study were to evaluate the effects of 18-h fasting with low-carbohydrate diet (LCD) vs a minimum of 6-h fasting preparations on diffuse LV FDG uptake and free fatty acid (FFA) levels in patients with suspected CS. Eighty-two patients with suspected CS were divided into 2 preparation protocols: one with a minimum 6-h fast without LCD preparation (group A, n = 58) and the other with a minimum 18-h fast with LCD preparation (group B, n = 24). All patients also received intravenous unfractionated heparin (UFH; 50 IU/kg) before the injection of FDG. Group A showed a higher percentage of diffuse LV uptake than did group B (27.6 vs 0.0%, P = .0041). Group B showed higher FFA levels (1159.1 ± 393.0, 650.5 ± 310.9 μEq/L, P < .0001) than did group A. Patients with diffuse LV uptake (n = 16) showed lower FFA levels than did other patients (n = 66) (432.1 ± 296.1, 888.4 ± 381.4 μEq/L, P < .0001). UFH administration significantly increased FFAs in both groups, even in the patients with diffuse LV FDG uptake. The 18-h fast with LCD preparation significantly reduced diffuse LV uptake and increased FFA levels. In particular, the FFA level was significantly lower in patients with LV diffuse uptake than in patients without LV diffuse uptake. Acutely increasing plasma FFA through the use of UFH may not have a significant role in reducing physiological LV FDG uptake.