Increased atrial FDG avidity correlates independently with reduced LA strain and enlarged LA volume, indicating metabolic atrial myopathy preceding atrial fibrillation.
Is increased atrial FDG avidity associated with left atrial remodeling and reduced strain in patients with suspected cardiac sarcoidosis?
Increased atrial FDG avidity is independently associated with impaired left atrial strain and enlargement, highlighting a metabolic component of atrial myopathy that may precede clinical atrial fibrillation.
Absolute Event Rate: 0% vs 0%
Abstract Aims Atrial myopathy encompasses structural, functional, electrical, and metabolic changes in the atrial myocardium. While remodeling such as left atrial (LA) dilation and reduced strain are well documented, metabolic alterations remain underexplored. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) provides a non-invasive tool to assess myocardial glucose metabolism. This study evaluates the relationship between atrial FDG avidity and LA remodeling in patients undergoing cardiac imaging for suspected cardiac sarcoidosis (CS). Methods We studied 120 patients who underwent both cardiac MRI and FDG-PET/CT at the University of Washington Medical Center. LA structural volume index (LAVi) and functional emptying fraction (LAEF), average long-axis strain, and phasic strain indices were derived from cine MRI using feature tracking. Atrial FDG avidity was quantified by SUVmax and atrial target-to-background ratio (aTBR) from PET/CT. Results LA average long axis strain was 37.1 ± 34.0%, LAEF 47.6 ± 16.1%, and LAVi 36.0 ± 23.0%. Atrial avidity was 2.4 ± 0.7 SUV. LA strain negatively and mildy correlated with both SUVmax (R= -0.44; P0.001) and moderately with aTBR (R= -0.53; P0.001), while LAVi positively and mildly correlated with both (R= 0.40 and R = 0.52, respectively; P 0.001). These associations persisted after adjusting for age, gender, diabetes, CS, history of AF, HR, and pre-PET scan rhythm status. AF patients exhibited reduced LA strain and higher FDG avidity. Conclusion Increased atrial FDG avidity is independently associated with impaired strain and enlarged LA, highlighting a metabolic component of atrial myopathy that may precede clinical AF.
Kassar et al. (Thu,) reported a other. Increased atrial FDG avidity correlates independently with reduced LA strain and enlarged LA volume, indicating metabolic atrial myopathy preceding atrial fibrillation.