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Does a fully automated method using a single 11C-acetate PET scan accurately estimate myocardial external efficiency compared to PET-CMR in patients with valvular disease and healthy controls?
Does a fully automated method using a single 11C-acetate PET scan accurately estimate myocardial external efficiency compared to PET-CMR in patients with valvular disease and healthy controls?
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A fully automated method using a single 11C-acetate PET scan accurately estimates myocardial external efficiency, which correlates with valvular dysfunction severity and NYHA class.
Myocardial external efficiency (MEE) is defined as the ratio of kinetic energy associated with cardiac work [forward cardiac output (FCO)*mean systemic pressure] and the chemical energy from oxygen consumed (MVO 2 ) by the left ventricular mass (LVM). We developed a fully automated method for estimating MEE based on a single 11 C-acetate PET scan without ECG-gating. Ten healthy controls, 34 patients with aortic valve stenosis (AVS), and 20 patients with mitral valve regurgitation (MVR) were recruited in a dual-center study. MVO 2 was calculated using washout of 11 C -acetate activity. FCO and LVM were calculated automatically using dynamic PET and parametric image formation. FCO and LVM were also obtained using cardiac magnetic resonance (CMR) in all subjects. The correlation between MEE PET-CMR and MEE PET was high ( r = 0.85, P < 0.001) without significant bias. MEE PET was 23.6 ± 4.2% for controls and was lowered in AVS (17.2 ± 4.3%, P < 0.001) and in MVR (18.0 ± 5.2%, P = 0.004). MEE PET was strongly associated with both NYHA class ( P < 0.001) and the magnitude of valvular dysfunction (mean aortic gradient: P < 0.001, regurgitant fraction: P = 0.009). A single 11 C-acetate PET yields accurate and automated MEE results on different scanners. MEE might provide an unbiased measurement of the phenotypic response to valvular disease.
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Harms et al. (2018) studied this question.
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