+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

PET imaging may provide a novel biomarker and understanding of right ventricular dysfunction in patients with idiopathic pulmonary arterial hypertension



PET imaging may provide a novel biomarker and understanding of right ventricular dysfunction in patients with idiopathic pulmonary arterial hypertension



Circulation. Cardiovascular Imaging 4(6): 641-647



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. 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). 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.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 036259677

Download citation: RISBibTeXText

PMID: 21926260

DOI: 10.1161/circimaging.110.963207


Related references

Impaired right ventricular myocardial perfusion and right ventricular dysfunction in patients with pulmonary arterial hypertension: a study of contrast echocardiography and strain imaging. European Heart Journal 34(Suppl 1): P1179-P1179, 2013

Regional right ventricular remodeling and function in children with idiopathic pulmonary arterial hypertension vs those with pulmonary valve stenosis: Insights into mechanics of right ventricular dysfunction. Echocardiography 34(6): 888-897, 2017

Strain and strain rate echocardiography for evaluation of right ventricular dysfunction in patients with idiopathic pulmonary arterial hypertension. Clinical Research in Cardiology 99(8): 491-498, 2010

Right ventricular sex differences in patients with idiopathic pulmonary arterial hypertension characterised by magnetic resonance imaging: pair-matched case controlled study. Plos one 10(5): E0127415, 2015

Pulmonary capillary endothelial metabolic dysfunction: severity in pulmonary arterial hypertension related to connective tissue disease versus idiopathic pulmonary arterial hypertension. Arthritis and Rheumatism 58(4): 1156-1164, 2008

Heart rate variability parameters and ventricular arrhythmia correlate with pulmonary arterial pressure in adult patients with idiopathic pulmonary arterial hypertension. Heart and Lung 43(6): 534-540, 2015

Prevalence and prognostic value of left ventricular diastolic dysfunction in idiopathic and heritable pulmonary arterial hypertension. Chest 141(6): 1457-1465, 2012

Assessment of Right Ventricular Function by Newer Imaging in Echocardiography in Idiopathic Pulmonary Arterial Hypertension. Cardiology Research 8(5): 214-219, 2017

Left ventricular dysfunction induced by nonsevere idiopathic pulmonary arterial hypertension: a pressure-volume relationship study. American Journal of Respiratory and Critical Care Medicine 186(2): 181-189, 2012

Comparison of 18F-FDG uptake by right ventricular myocardium in idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with congenital heart disease. Pulmonary Circulation 2(3): 365-372, 2012

Differences in Right Ventricular Functional Changes during Treatment between Systemic Sclerosis-associated Pulmonary Arterial Hypertension and Idiopathic Pulmonary Arterial Hypertension. Annals of the American Thoracic Society 14(5): 682-689, 2017

Skeletal muscle dysfunction in patients with idiopathic pulmonary arterial hypertension. Respiratory Medicine 101(11): 2366-2369, 2007

Right Ventricular Hypertrophy Electrocardiogram Index Agreement With Magnetic Resonance Imaging In Idiopathic Arterial Pulmonary Hypertension. Chest 134(4): p137001-a-p137001-b, 2008

Initial Riociguat Monotherapy and Transition from Sildenafil to Riociguat in Patients with Idiopathic Pulmonary Arterial Hypertension: Influence on Right Heart Remodeling and Right Ventricular-Pulmonary Arterial Coupling. Lung 196(6): 745-753, 2018

ECG signs of right ventricular hypertrophy may help distinguish pulmonary arterial hypertension and pulmonary hypertension due to left ventricular diastolic dysfunction. Bratislavske Lekarske Listy 112(11): 614-618, 2011