Key result
LGE mass does not correlate with RV insertion point FDG uptake in PAH.
Why the study?
LGE in RVIPs is common in PAH and often considered myocardial fibrosis, but its relationship with myocardial metabolic activity was unknown.
Observational (n=28)
No
Answers are grounded in this paper and cite their sources.
The lack of inverse correlation between LGE mass and FDG uptake suggests that LGE in right ventricle insertion points is metabolically active and unlikely to be simple fibrotic change in PAH patients.
Presence of late gadolinium enhancement (LGE) in right ventricle insertion points (RVIPs) has been found in majority of pulmonary arterial hypertension (PAH) patients and is often recognized as evidence of myocardial fibrosis. The aim of the study was to evaluate the relationship between LGE mass and myocardium metabolic activity in RVIPs using PET/MRI imaging. Twenty-eight clinically stable PAH patients had PET/MRI scans during baseline and 2-year follow up (FU) visits. Fluorodeoxyglucose cardiac uptake was assessed in the area of LGE (SUV RVIPS ). Clinical end-point (CEP) was defined as death or clinical deterioration. Mean LGE mass in RVIPs was 6.67±4.41 g and mean SUV RVIPS was 7.28±5.36. FU values were 8.01±7.75 g (p=0.27) and 5.81±3.16 (p=0.16), respectively. Decrease of SUV RVIPS was observed in 70% (n=14) cases. No statistically significant correlation was found between LGE mass and SUV RVIPS (in both baseline and FU scans). PAH therapy have an impact on both LGE mass and FDG uptake in cardiac local tissue changes. Lack of reverse correlation between those two parameters suggests that LGE is not less metabolically active than the surrounding myocardium and hence it is unlikely to be simple fibrotic change, however this finding requires further studies. Trial Registration: Clinical Trials.gov; NCT03688698, 09/26/2018, retrospectively registered; Protocol ID: 2017/25/N/NZ5/02689l https://clinicaltrials.gov/ct2/show/NCT03688698
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Kazimierczyk et al. (2023) conducted an observational in Pulmonary arterial hypertension (n=28). Standard PAH therapy vs. Baseline was evaluated on Correlation between LGE mass and SUVRVIPS at baseline (r=-0.05, p=0.76). In patients with pulmonary arterial hypertension, there was no significant correlation between late gadolinium enhancement mass and fluorodeoxyglucose uptake in right ventricle insertion points (r=-0.05, p=0.76).
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