Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Identifying Hypoxia and Glycolysis in Chemotherapy- and Radiation-Induced Cardiotoxicity by Nuclear Medicine Diagnostic Imaging With 18F-Flurodeoxyglucose – Key Role of Coenzyme Q10 Deficiency in Acquired Mitochondrial Dysfunction

Version 1 : Received: 5 February 2024 / Approved: 5 February 2024 / Online: 5 February 2024 (10:00:22 CET)

How to cite: Moncayo, R.; Moncayo, H. Identifying Hypoxia and Glycolysis in Chemotherapy- and Radiation-Induced Cardiotoxicity by Nuclear Medicine Diagnostic Imaging With 18F-Flurodeoxyglucose – Key Role of Coenzyme Q10 Deficiency in Acquired Mitochondrial Dysfunction. Preprints 2024, 2024020256. https://doi.org/10.20944/preprints202402.0256.v1 Moncayo, R.; Moncayo, H. Identifying Hypoxia and Glycolysis in Chemotherapy- and Radiation-Induced Cardiotoxicity by Nuclear Medicine Diagnostic Imaging With 18F-Flurodeoxyglucose – Key Role of Coenzyme Q10 Deficiency in Acquired Mitochondrial Dysfunction. Preprints 2024, 2024020256. https://doi.org/10.20944/preprints202402.0256.v1

Abstract

Cardiotoxicity is an unwanted side-effect arising from different medications. The term describes a diminution of heart function, affecting especially left ventricular ejection fraction, which can progress to heart failure. Pediatric oncology patients treated with drugs of the anthracycline group, e.g., doxorubicin, can evolve to heart failure patients in adult age. Nuclear Medicine imaging of fatty acid oxidation and glycolysis accurately describes normal and altered heart metabolism. The most common finding is a state of cardiac glycolysis, which is reflected by increased uptake of 18F-desoxyglucose (18F-FDG) at a time when fatty acid oxidation is decreased. Glycolysis has recently been recognized as being the result of coenzyme Q10 deficiency as part of adaptation to hypoxia. Low LEVF correlates with impaired fatty acid oxidation. This deficiency can arise from chemotherapy and radiation and can be corrected by supplementation. Drugs like enalapril can improve fatty acid utilization. We will review relevant Nuclear Medicine imaging studies as well as fundamental biochemical data that demonstrate this pathogenetic path.

Keywords

Coenzyme Q10; glycolysis; hypoxia; 18fluoro-desoxyglucose; 18F-FDG; positron emission tomography; BMIPP; fatty acid oxidation; baseline diagnosis; pediatric oncology; post-partum cardiomyopathy.

Subject

Medicine and Pharmacology, Oncology and Oncogenics

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