Key result
PET/CT SUVmax RV/LV perfusion and metabolism ratios track with risk status in IPAH.
Why the study?
Right ventricular heart failure is the leading cause of death in pulmonary arterial hypertension, and the relevance of low-risk status assessment using available diagnostic tools requires reliable confirmation.
Does PET/CT imaging of right heart perfusion and glucose metabolism correlate with risk status in patients with idiopathic pulmonary arterial hypertension?
Observational (n=30)
Does PET/CT imaging of right heart perfusion and glucose metabolism correlate with risk status in patients with idiopathic pulmonary arterial hypertension?
Increased SUVmax RV/LV perfusion on PET/CT may serve as an early marker of coronary flow adaptation to right ventricular pressure overload in low-risk IPAH patients.
May support PET/CT as early RV perfusion marker in low-risk IPAH; hypothesis-generating and requires prospective validation before clinical adoption.
Right ventricular heart failure (RV HF) is the leading cause of death in pulmonary arterial hypertension (PAH). Relevance of the low‐risk status assessment using available diagnostic tools requires a reliable confirmation. The study aimed to evaluate right ventricular perfusion and glucose metabolism using positron emission tomography (PET)/computed tomography (CT) with [13N]‐ammonia and [18F]‐fluorodeoxyglucose ([18F]‐FDG) in 30 IPAH patients (33.8 ± 9.4 years) according to ESC/ERS 2022 risk status. The ratio of SUVmax RV/LV metabolism and SUVmax RV/LV perfusion showed significant positive correlation with pulmonary artery pressure, right heart dilatation, NT‐proBNP level and negative correlation with the RV ejection fraction. The SUVmax RV/LV perfusion and SUVmax RV/LV metabolism ratios differed significantly according to risk status. Low risk patients had a SUVmax RV/LV metabolism comparable to the controls without PH. The SUVmax RV/LV perfusion ratio was elevated in low‐risk IPAH patients compared with controls. Increased SUVmax RV/LV perfusion may be an early marker of coronary flow adaptation to RV pressure overload in low‐risk IPAH patients and requires further evaluation. Further long‐term studies are needed to determine the clinical relevance and cut‐off values for the RV/LV PET/CT with [13N]‐ammonia and [18F]‐fluorodeoxyglucose ([18F]‐FDG) uptake in different IPAH risk groups.
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Гончарова et al. (2025) conducted an observational in Idiopathic Pulmonary Arterial Hypertension (n=30). PET/CT with [13N]-ammonia and [18F]-FDG vs. Controls without pulmonary hypertension was evaluated on Right ventricular perfusion and glucose metabolism (SUVmax RV/LV ratios). PET/CT imaging showed SUVmax RV/LV perfusion and metabolism ratios differed significantly by risk status, with elevated perfusion in low-risk IPAH patients versus controls.
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