Lei Wang1,2, Weihua Zhou3, Yu Liang4, Yong Yang1, Ernest V Garcia5, Ji Chen5, Wei Fang6. 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, United Kingdom. 3. School of Computing, University of Southern Mississippi, 730 East Beach Blvd, Long Beach, MS, 39560, USA. weihua.zhou@usm.edu. 4. Department of Echocardiography, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China. 5. Department of Radiology, Emory University School of Medicine, Atlanta, GA, 30322, USA. 6. 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
BACKGROUND: Right ventricular (RV) performance in patients of pulmonary hypertension (PH) requires optimal assessment. The objective of this study is to develop phase analysis using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging as a feasible tool for evaluation of RV dyssynchrony in PH. METHODS AND RESULTS: Fifty-four PH patients with well-characterized hemodynamic parameters were enrolled. All subjects performed FDG-PET imaging for RV phase analysis and RV function evaluation. Two-dimensional echocardiography with speckle tracking analysis was conducted to obtain RV time to peak systolic strain (PSST) as a comparison. The median contraction delay difference between RV middle free wall and septum measured by PET phase analysis (RVPDPET) was 20.12° (interquartile range, 4.99°-30.10°). The median difference of PSST between RV middle free wall and middle septal wall (RVPDEcho) measured by echocardiography was 43.98° (interquartile range, 6.25°-72.00°). RVPDPET was well correlated with RVPDEcho (r = 0.685, P < .001). RV phase standard deviation (RVSD) and histogram bandwidth (RVBW) derived from PET phase histogram were significantly correlated with cardiac index, RV ejection fraction, 6-minute walking distance, and serum N-terminal pro B-type natriuretic peptide (NT-proBNP) (RVSD: r = -0.532, P < .001; r = -0.551, P < .001; r = -0.544, P < .001; r = 0.404, P < .01; respectively, RVBW: r = -0.492, P < .001; r = -0.466, P < .001; r = -0.544, P < .001; r = 0.349, P = .01, respectively), while there were no significant correlations between RVSD and RVBW with hemodynamic parameters (right atrial pressure, right ventricular systolic pressure, right ventricular end-diastolic pressure, mean pulmonary artery pressure, and total pulmonary resistance). CONCLUSIONS: Contraction delays between RV free wall and septum in PH measured by phase analysis and speckle tracking echocardiography were well correlated. RV dyssynchrony measured by phase analysis of FDG-PET was significantly related to RV dysfunction. Phase analysis of FDG-PET is feasible to evaluate RV mechanical dyssynchrony in patients of PH.
BACKGROUND: Right ventricular (RV) performance in patients of pulmonary hypertension (PH) requires optimal assessment. The objective of this study is to develop phase analysis using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging as a feasible tool for evaluation of RV dyssynchrony in PH. METHODS AND RESULTS: Fifty-four PH patients with well-characterized hemodynamic parameters were enrolled. All subjects performed FDG-PET imaging for RV phase analysis and RV function evaluation. Two-dimensional echocardiography with speckle tracking analysis was conducted to obtain RV time to peak systolic strain (PSST) as a comparison. The median contraction delay difference between RV middle free wall and septum measured by PET phase analysis (RVPDPET) was 20.12° (interquartile range, 4.99°-30.10°). The median difference of PSST between RV middle free wall and middle septal wall (RVPDEcho) measured by echocardiography was 43.98° (interquartile range, 6.25°-72.00°). RVPDPET was well correlated with RVPDEcho (r = 0.685, P < .001). RV phase standard deviation (RVSD) and histogram bandwidth (RVBW) derived from PET phase histogram were significantly correlated with cardiac index, RV ejection fraction, 6-minute walking distance, and serum N-terminal pro B-type natriuretic peptide (NT-proBNP) (RVSD: r = -0.532, P < .001; r = -0.551, P < .001; r = -0.544, P < .001; r = 0.404, P < .01; respectively, RVBW: r = -0.492, P < .001; r = -0.466, P < .001; r = -0.544, P < .001; r = 0.349, P = .01, respectively), while there were no significant correlations between RVSD and RVBW with hemodynamic parameters (right atrial pressure, right ventricular systolic pressure, right ventricular end-diastolic pressure, mean pulmonary artery pressure, and total pulmonary resistance). CONCLUSIONS: Contraction delays between RV free wall and septum in PH measured by phase analysis and speckle tracking echocardiography were well correlated. RV dyssynchrony measured by phase analysis of FDG-PET was significantly related to RV dysfunction. Phase analysis of FDG-PET is feasible to evaluate RV mechanical dyssynchrony in patients of PH.
Entities:
Keywords:
Fluorodeoxyglucose; dyssynchrony; phase analysis; pulmonary hypertension; right ventricle
Authors: Aju P Pazhenkottil; Ronny R Buechel; Bernhard A Herzog; Rene N Nkoulou; Ines Valenta; Ursula Fehlmann; Jelena-Rima Ghadri; Mathias Wolfrum; Lars Husmann; Philipp A Kaufmann Journal: Eur J Nucl Med Mol Imaging Date: 2010-06-17 Impact factor: 9.236
Authors: Benjamin C F Smith; Gary Dobson; David Dawson; Athanasios Charalampopoulos; Julia Grapsa; Petros Nihoyannopoulos Journal: J Am Coll Cardiol Date: 2014-07-08 Impact factor: 24.094
Authors: Nazzareno Galiè; Marius M Hoeper; Marc Humbert; Adam Torbicki; Jean-Luc Vachiery; Joan Albert Barbera; Maurice Beghetti; Paul Corris; Sean Gaine; J Simon Gibbs; Miguel Angel Gomez-Sanchez; Guillaume Jondeau; Walter Klepetko; Christian Opitz; Andrew Peacock; Lewis Rubin; Michael Zellweger; Gerald Simonneau Journal: Eur Heart J Date: 2009-08-27 Impact factor: 29.983
Authors: Maureen M Henneman; Ji Chen; Claudia Ypenburg; Petra Dibbets; Gabe B Bleeker; Eric Boersma; Marcel P Stokkel; Ernst E van der Wall; Ernest V Garcia; Jeroen J Bax Journal: J Am Coll Cardiol Date: 2007-04-05 Impact factor: 24.094
Authors: Jane A Leopold; Steven M Kawut; Micheala A Aldred; Stephen L Archer; Ray L Benza; Michael R Bristow; Evan L Brittain; Naomi Chesler; Frances S DeMan; Serpil C Erzurum; Mark T Gladwin; Paul M Hassoun; Anna R Hemnes; Tim Lahm; Joao A C Lima; Joseph Loscalzo; Bradley A Maron; Laura Mercer Rosa; John H Newman; Susan Redline; Stuart Rich; Franz Rischard; Lissa Sugeng; W H Wilson Tang; Ryan J Tedford; Emily J Tsai; Corey E Ventetuolo; YouYang Zhou; Neil R Aggarwal; Lei Xiao Journal: Circ Heart Fail Date: 2021-06-15 Impact factor: 10.447