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Positron emission tomography (PET) permits in vivo as well as noninvasive study of fatty acid metabolism. Parameters of 11C-palmitate kinetics relate to the oxidation of fatty acids, and palmitic acid uptake is impaired in patients with coronary disease and cardiomyopathy. Normal myocardium shows homogenous fatty acid·metabolism and can resort to alternate substrates. Diseased myocardium exhibits regional heterogeneity in fatty acid uptake and utilization. In patients with cardiomyopathy, distinct patterns of fatty acid metabolism can be observed following changes of substrate availability by application of an oral glucose load. This intervention also enhances the heterogeneity of 11C-palmitic acid (CPA) uptake and clearance. Thus, PET studies with CPA permit the noninvasive demonstration of effects on substrate availability and may help to characterize patients with ventricular dysfunction on the biochemical level.

Summary The cineventriculograms were examined in 12 healthy subjects and 24 patients with coronary heart disease. In each ventricle the mean velocity of circumferential fiber shortening was determined for three different regions (B, D and A). In addition, the increase in left ventricular wall thickness was measured. In the 12 normal left ventricles the mean velocity of circumferential fiber shortening (VCF) averaged 1.26±0.05 circ/sec in region B, 1.25±0.07 in D and 1.26±0.07 circ/sec in A respectively. There was an average increase in wall thickness of 47.4±14.3% in region B, of 42.6±7.5% in D and of 44.2±7.9% in A, respectively. In the 24 ventricles with coronary artery disease VCF was clearly diminished in all regions and averaged 0.85±0.06 circ/sec in B, 0.68±0.08 in D and 0.66±0.06 circ/sec in A. The results indicate that fibers shortening in the normal left ventricle occurs in the three regions nearly uniformly and at the same speed. In ventricles with coronary artery disease, however, VCF is decreased and shows marked differences between the three regions. By averaging VCF of the 3 regions for each ventricle, total left ventricular function can be determined. Local disturbances in left ventricular function can be recognized by dividing the difference between maximal and minimal VCF by the maximal VCF. The index is called ?max/VCFmax and allows to separate normal left ventricles from those with coronary artery disease. Local disorders in left ventricular function could be demonstrated using the index in 95% of the patients with coronary heart disease.

Summary A method for the rapid determination of left ventricular cavity areas in angiocardiograms has been developed. The angiocardiographic information is transformed into a videosignal and evaluated by an electronic analogue circuitry. Exact measurements could be obtained only by using a new electronic device which corrects for the inhomogeneous background of the angiocardiograms. The method was used in 193 angiocardiograms. The results showed good correlation with those obtained by conventional planimetry (r = 0.99 in the ant. post., 0.95 in the lat. view).