Myocardial glucose metabolism assessed by positron emission tomography and the histopathologic findings of microvessels in syndrome X.

Background: Syndrome X has been recognized as a disease that is primarily reflected in the cardiac microvasculature. Myocardial metabolism in this condition has been studied, but not in relation to small vessel pathology.

Methods And Results: In order to examine the relationship between myocardial metabolism and small vessel pathology, 24 consecutive patients with syndrome X (7 men, 17 women; mean age 58 years) were evaluated by the thallium exercise stress test, positron emission tomography using F-18 fluoro-deoxyglucose (FDG), and an endomyocardial biopsy.

Case report: unstable angina with flow-fatty acid metabolism mismatch and reverse flow-glucose metabolism mismatch patterns.

A 79-year-old man with unstable angina underwent an emergency coronary angiography, and percutaneous balloon angioplasty was performed for LCX. Left ventriculography showed hypokinesis in the posterior wall, inferior and apical wall immediately after the PCI therapy. The defects on 123I-BMIPP SPECT seen in the inferior, posterior and lateral wall were more extensive than those observed on 99mTc-MIBI SPECT, and a flow-fatty acid metabolism mismatch pattern was observed.