Metabolic characteristics of the infarct zone: PET findings

A sudden reduction in luminal diameter or a complete occlusion of a coronary artery triggers a cascade of metabolic events leading to myocardial ischemia. These events may differ from the slowly progressing narrowing of the coronary lumen due to developing atherosclerosis which allows for formation of collateral vessels. Yet, both situations are interrelated. They lead to an impairment of contractile function and to metabolic changes in the dependent myocardium. Considerable research has focused on elucidating mechanisms underlying the ischemia related changes in metabolism. Yet, the study of metabolism, especially in humans, has been limited. Tissue sampling for measurements of metabolites is highly invasive and provides only very regional information. Alternatively, collection of blood draining from the coronary sinus provides information on only average but not regional changes.