Automatic calculation of myocardial external efficiency using a single {sup 11}C-acetate PET scan

Background: Myocardial external efficiency (MEE) is defined as the ratio of kinetic energy associated with cardiac work [forward cardiac output (FCO)*mean systemic pressure] and the chemical energy from oxygen consumed (MVO{sub 2}) by the left ventricular mass (LVM). We developed a fully automated method for estimating MEE based on a single {sup 11}C-acetate PET scan without ECG-gating. Methods and Results: Ten healthy controls, 34 patients with aortic valve stenosis (AVS), and 20 patients with mitral valve regurgitation (MVR) were recruited in a dual-center study. MVO{sub 2} was calculated using washout of {sup 11}C -acetate activity. FCO and LVM were calculated automatically using dynamic PET and parametric image formation. FCO and LVM were also obtained using cardiac magnetic resonance (CMR) in all subjects. The correlation between MEE{sub PET-CMR} and MEE{sub PET} was high (r = 0.85, P