Myocardial metabolism is essential for cardiac contraction and maintenance
of cell integrity. Under aerobic, fasting conditions, the primary myocardial substrates
are fatty acids. Imaging of myocardial metabolic processes in vivo yields valuable
insights into myocardial pathophysiological mechanisms. Thereby, it offers a better
understanding of various cardiac diseases and may contribute to the evaluation of
therapeutic effectiveness of various interventions. Consequently, there is a great
interest regarding the development of reliable non-invasive techniques for the imaging
of myocardial substrate metabolism. This chapter focuses on several single photon
emission computed tomography (SPECT) and positron emission tomography (PET)
tracers for the assessment of myocardial fatty acid metabolism. In addition, the impact
of different clinical conditions on fatty acid metabolism is discussed, and how these
changes in metabolism can be assessed with the radiolabelled tracers.
Keywords: Acetate, Beta-oxidation, Fatty acids, Metabolism, Myocardial
ischemia, Myocardium, Palmitate, Positron emission tomography, Radiolabelled
tracers, Single photon emission computed tomography.
