Atrial fibrillation was strongly associated with higher odds of FDG uptake in the left atrium (OR 14.50; 95% CI 6.78-31.02; P<.0001) and right atrium (OR 51.98) compared to non-AF patients.
Meta-Analysis (n=832)
Is atrial fibrillation associated with increased atrial FDG uptake on PET imaging in patients without cardiac sarcoidosis?
Atrial fibrillation is strongly associated with increased FDG uptake in the left and right atria on PET imaging, suggesting a role for altered metabolism or inflammation in AF pathophysiology.
Effect estimate: OR 14.50 (95% CI 6.78-31.02)
p-value: p=<.0001
Background Atrial inflammatory and metabolic derangements have been reported in patients with atrial fibrillation (AF). Objective We sought to evaluate the association of 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) in the left and right atria and AF. Methods We conducted a systematic review and meta-analysis, using the PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, of studies involving patients undergoing FDG-PET scans with reported atrial or ventricular uptake and outcomes of AF. Data were pooled and analyzed, and FDG uptake in AF and non-AF patients was compared using odds ratios (ORs). Results Six studies (4 retrospective, 1 prospective, and 1 case-control) were included in the meta-analysis of studies on patients not meeting diagnostic criteria for cardiac sarcoidosis (CS): 832 patients with a mean age of 67 years, 62% male, and 53% with hypertension. AF patients demonstrated higher odds of FDG uptake in the left atrium (pooled OR 14.50, 95% confidence interval 6.78–31.02; P I2 = 0) and right atrium (pooled OR 51.98, 95% confidence interval 22.77–118.63, P I2 = 0). Two studies on patients met diagnostic criteria for CS: one did not report atrial uptake and the other did not demonstrate a statistically significant association between right or left atrial uptake in AF patients. Conclusion In patients undergoing FDG-PET without meeting CS diagnostic criteria, FDG uptake in the atria was strongly associated with AF, suggesting altered metabolism or inflammation in AF pathophysiology and risk assessment.
Kassar et al. (Fri,) conducted a meta-analysis in Atrial fibrillation (n=832). Atrial fibrillation vs. Non-AF patients was evaluated on FDG uptake in the left atrium (OR 14.50, 95% CI 6.78-31.02, p=<.0001). Atrial fibrillation was strongly associated with higher odds of FDG uptake in the left atrium (OR 14.50; 95% CI 6.78-31.02; P<.0001) and right atrium (OR 51.98) compared to non-AF patients.
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