The ratio of right to left ventricular myocardial glucose uptake measured by PET correlated significantly with mean pulmonary artery pressure (r=0.87, P=0.001) in patients with idiopathic PAH.
Observational (n=16)
Does PET metabolic and perfusion imaging correlate with clinical parameters of right ventricular dysfunction in patients with idiopathic PAH?
PET scanning with (13)N-NH(3) and (18)F-FDG is a feasible noninvasive modality for quantifying right ventricular blood flow and metabolism, which correlate with pulmonary artery pressures in idiopathic PAH.
Effect estimate: r=0.87
p-value: p=0.001
BACKGROUND: The clinical course in pulmonary arterial hypertension (PAH) is variable, and there is limited information on the determinants and progression of right ventricular (RV) dysfunction. The objective is to develop PET metabolic imaging of the RV as a noninvasive tool in patients with PAH. METHODS AND RESULTS: We performed PET scanning in 16 patients with idiopathic PAH (age, 41±14 years, 82% women) using (13)N-NH(3) for perfusion imaging and (18)F-fluorodeoxyglucose for metabolic imaging. The myocardium was divided into 6 regions of interest (3 left ventricular LV, 3 RV), and time-activity curves were generated. A 2- compartment model was used to calculate myocardial blood flow (MBF), and Patlak analysis was used to calculate the rate of myocardial glucose uptake (MGU). All patients underwent cardiac catheterization, cardiac MRI, and cardiopulmonary exercise testing with gas exchange. MBF, MGU, and the ratio of RV/LV MGU were correlated to clinical parameters. Pulmonary artery (PA) pressure was 79±19/30±8 mm Hg (mean, 48±10 mm Hg). MBF was 0.84±0.33 mL/g per minute for the LV and 0.45±0.14 mL/g per minute for the RV. Mean MGU was 136±72 nmol/g per minute for the LV and 96±69 nmol/g per minute for the RV. The ratio of RV/LV MGU correlated significantly with PA systolic (r=0.75, P=0.0085) and mean (r=0.87, P=0.001) pressure and marginally with maximum oxygen consumption (r=-0.59, P=0.05). RV free wall MGU also correlated well with mean PA pressure (r=0.66, P=0.03). CONCLUSIONS: PET scanning with (13)N-NH(3) and (18)F-fluorodeoxyglucose is a feasible modality for quantifying RV blood flow and metabolism in patients with idiopathic PAH.
Bokhari et al. (Sat,) conducted a observational in Idiopathic Pulmonary Arterial Hypertension (n=16). PET scanning with (13)N-NH(3) and (18)F-fluorodeoxyglucose was evaluated on Correlation of RV/LV MGU ratio with mean PA pressure (r=0.87, p=0.001). The ratio of right to left ventricular myocardial glucose uptake measured by PET correlated significantly with mean pulmonary artery pressure (r=0.87, P=0.001) in patients with idiopathic PAH.
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