TY - JOUR
T1 - Multiparametric assessment of left atrial remodeling using 18F-FDG PET/CT cardiac imaging
T2 - A pilot study
AU - Ghannam, Michael
AU - Yun, Hong Jun
AU - Ficaro, Edward P.
AU - Ghanbari, Hamid
AU - Lazarus, John J.
AU - Konerman, Matthew
AU - Shah, Ravi V.
AU - Weinberg, Richard
AU - Corbett, James R.
AU - Oral, Hakan
AU - Murthy, Venkatesh L.
N1 - Funding Information:
Drs. Ficaro and Corbett own equity in INVIA Medical Imaging Solutions. Dr. Murthy owns stock in General Electric and Cardinal Health, owns stock options and has received consulting fees from Ionetix, and has received research grants from Siemens Medical Imaging. Dr. Murthy is supported by Grant R01HL136685 from the National, Heart, Lung, and Blood Institute and R01AG059729 from the National Institute on Aging. Drs. Ghannam, Yun, Ghanbari, Lazarus, Konerman, Shah, Weinberg, and Oral have no disclosures or conflicts of interest related to this publication.
Publisher Copyright:
© 2018, American Society of Nuclear Cardiology.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: Left atrial (LA) remodeling is associated with structural, electric, and metabolic LA changes. Integrated evaluation of these features in vivo is lacking. Methods: Patients undergoing 18F-fluorodeoxyglucose (FDG) PET-CT during a hyperinsulinemic-euglycemic clamp were classified into sinus rhythm (SR), paroxysmal AF (PAF), and persistent AF (PerAF). The LA was semiautomatically segmented, and global FDG uptake was quantified using standardized uptake values (SUVmax and SUVmean) in gated, attenuation-corrected images and normalized to LA blood pool activity. Regression was used to relate FDG data to AF burden and critical patient factors. Continuous variables were compared using t-tests or Mann-Whitney tests. Results: 117 patients were included (76% men, age 66.4 ± 11.0, ejection fraction (EF) 25[22-35]%) including those with SR (n = 48), PAF (n = 55), and PerAF (n = 14). Patients with any AF had increased SUVmean (2.3[1.5-2.4] vs 2.0[1.5-2.5], P = 0.006), SUVmax (4.4[2.8-6.7] vs 3.2[2.3-4.3], P < 0.001), uptake coefficient of variation (CoV) 0.28[0.22-0.40] vs 0.25[0.2-0.33], P < 0.001), and hypometabolic scar (32%[14%-53%] vs 16.5%[0%-38.5%], P = 0.01). AF burden correlated with increased SUVmean, SUVmax, CoV, and scar independent of age, gender, EF, or LA size (P < 0.03 for all). Conclusions: LA structure and metabolism can be assessed using FDG PET/CT. Greater AF burden correlates with the increased LA metabolism and scar.
AB - Background: Left atrial (LA) remodeling is associated with structural, electric, and metabolic LA changes. Integrated evaluation of these features in vivo is lacking. Methods: Patients undergoing 18F-fluorodeoxyglucose (FDG) PET-CT during a hyperinsulinemic-euglycemic clamp were classified into sinus rhythm (SR), paroxysmal AF (PAF), and persistent AF (PerAF). The LA was semiautomatically segmented, and global FDG uptake was quantified using standardized uptake values (SUVmax and SUVmean) in gated, attenuation-corrected images and normalized to LA blood pool activity. Regression was used to relate FDG data to AF burden and critical patient factors. Continuous variables were compared using t-tests or Mann-Whitney tests. Results: 117 patients were included (76% men, age 66.4 ± 11.0, ejection fraction (EF) 25[22-35]%) including those with SR (n = 48), PAF (n = 55), and PerAF (n = 14). Patients with any AF had increased SUVmean (2.3[1.5-2.4] vs 2.0[1.5-2.5], P = 0.006), SUVmax (4.4[2.8-6.7] vs 3.2[2.3-4.3], P < 0.001), uptake coefficient of variation (CoV) 0.28[0.22-0.40] vs 0.25[0.2-0.33], P < 0.001), and hypometabolic scar (32%[14%-53%] vs 16.5%[0%-38.5%], P = 0.01). AF burden correlated with increased SUVmean, SUVmax, CoV, and scar independent of age, gender, EF, or LA size (P < 0.03 for all). Conclusions: LA structure and metabolism can be assessed using FDG PET/CT. Greater AF burden correlates with the increased LA metabolism and scar.
KW - Metabolic
KW - PET
KW - cardiomyopathy
KW - echo
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U2 - 10.1007/s12350-018-1429-y
DO - 10.1007/s12350-018-1429-y
M3 - Article
C2 - 30191438
AN - SCOPUS:85053465606
SN - 1071-3581
VL - 27
SP - 1547
EP - 1562
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 5
ER -