Lei Wang1,2, Xinghong Ma1, Liwei Xiang3, Minjie Lu3, Chaowu Yan3, Shihua Zhao4, Wei Fang5. 1. Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China. 2. Centre for Pharmacology and Therapeutics, Experimental Medicine, Imperial College London, London, UK. 3. Department of Radiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China. 4. Department of Radiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China. cjr.zhaoshihua@vip.163.com. 5. Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China. nuclearfw@126.com.
Abstract
AIMS: In dilated cardiomyopathy (DCM), there are limited data on right ventricular (RV) glucose metabolism assessed by [(18)F]fludeoxyglucose positron emission tomography ((18)F-FDG PET) imaging. We aimed to characterize RV glucose metabolism and investigate the prognostic significance of RV FDG uptake in DCM. METHODS AND RESULTS: (18)F-FDG PET imaging and cardiac magnetic resonance imaging (MRI) were performed in 63 consecutive DCM patients within an interval of 3-7 days. There was a significant correlation between RVEF and RV FDG uptake whether corrected RV standard uptake value (cRVSUV) (r = -0.571, P < .001) or the relative RV FDG uptake determined as the ratio of RV to left ventricular (LV) corrected SUV (cR/L) (r = -0.405, P < .001) was used. During a median follow-up period of 804 days, 15 patients (23.8%) reached the primary endpoint of all-cause mortality or heart transplantation. On univariate Cox analysis, cRVSUV > 7.01 and cR/L > 0.795 were significantly associated with the overall survival (hazard ratio [HR] 5.415, 95% confidence interval [CI] 1.945-15.078, P < .001; HR 6.422, 95% CI 2.250-18.332, P < .001). Patients with increased RV FDG uptake had a worse outcome (cRVSUV > 7.01 vs cRVSUV ≤ 7.01, log-rank 13.085, P < .001; cR/L > 0.795 vs cR/L ≤ 0.795, log-rank 15.695, P < .001). On multivariate analysis, cR/L > 0.795 remained a significant independent predictor of the endpoint (HR 5.001, 95% CI 1.641-15.239, P = .004), while cRVSUV > 7.01 showed no significance (HR 2.611; 95% CI 0.797-8.558; P = .113). CONCLUSIONS: Increased RV FDG uptake was associated with RV dysfunction and may be a prognostic predictor of all-cause mortality or heart transplantation in patients with DCM.
AIMS: In dilated cardiomyopathy (DCM), there are limited data on right ventricular (RV) glucose metabolism assessed by [(18)F]fludeoxyglucose positron emission tomography ((18)F-FDG PET) imaging. We aimed to characterize RV glucose metabolism and investigate the prognostic significance of RV FDG uptake in DCM. METHODS AND RESULTS: (18)F-FDG PET imaging and cardiac magnetic resonance imaging (MRI) were performed in 63 consecutive DCMpatients within an interval of 3-7 days. There was a significant correlation between RVEF and RV FDG uptake whether corrected RV standard uptake value (cRVSUV) (r = -0.571, P < .001) or the relative RV FDG uptake determined as the ratio of RV to left ventricular (LV) corrected SUV (cR/L) (r = -0.405, P < .001) was used. During a median follow-up period of 804 days, 15 patients (23.8%) reached the primary endpoint of all-cause mortality or heart transplantation. On univariate Cox analysis, cRVSUV > 7.01 and cR/L > 0.795 were significantly associated with the overall survival (hazard ratio [HR] 5.415, 95% confidence interval [CI] 1.945-15.078, P < .001; HR 6.422, 95% CI 2.250-18.332, P < .001). Patients with increased RV FDG uptake had a worse outcome (cRVSUV > 7.01 vs cRVSUV ≤ 7.01, log-rank 13.085, P < .001; cR/L > 0.795 vs cR/L ≤ 0.795, log-rank 15.695, P < .001). On multivariate analysis, cR/L > 0.795 remained a significant independent predictor of the endpoint (HR 5.001, 95% CI 1.641-15.239, P = .004), while cRVSUV > 7.01 showed no significance (HR 2.611; 95% CI 0.797-8.558; P = .113). CONCLUSIONS: Increased RV FDG uptake was associated with RV dysfunction and may be a prognostic predictor of all-cause mortality or heart transplantation in patients with DCM.
Entities:
Keywords:
FDG PET; dilated cardiomyopathy; glucose metabolism; prognosis; right ventricle
Authors: Lisa M Mielniczuk; David Birnie; Maria C Ziadi; Robert A deKemp; Jean N DaSilva; Ian Burwash; Anthony T Tang; Ross A Davies; Haissam Haddad; Ann Guo; May Aung; Kathryn Williams; Heikki Ukkonen; Rob S B Beanlands Journal: Circ Cardiovasc Imaging Date: 2010-11-05 Impact factor: 7.792
Authors: Ankur Gulati; Tevfik F Ismail; Andrew Jabbour; Francisco Alpendurada; Kaushik Guha; Nizar A Ismail; Sadaf Raza; Jahanzaib Khwaja; Tristan D H Brown; Kishen Morarji; Emmanouil Liodakis; Michael Roughton; Ricardo Wage; Tapesh C Pakrashi; Rakesh Sharma; John-Paul Carpenter; Stuart A Cook; Martin R Cowie; Ravi G Assomull; Dudley J Pennell; Sanjay K Prasad Journal: Circulation Date: 2013-08-21 Impact factor: 29.690