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01.06.2014 | Original Article | Ausgabe 6/2014

European Journal of Nuclear Medicine and Molecular Imaging 6/2014

Attenuated right ventricular energetics evaluated using 11C-acetate PET in patients with pulmonary hypertension

Zeitschrift:
European Journal of Nuclear Medicine and Molecular Imaging > Ausgabe 6/2014
Autoren:
Keiichiro Yoshinaga, Hiroshi Ohira, Ichizo Tsujino, Noriko Oyama-Manabe, Lisa Mielniczuk, Rob S. B. Beanlands, Chietsugu Katoh, Katsuhiko Kasai, Osamu Manabe, Takahiro Sato, Satoshi Fujii, Yoichi M. Ito, Yuuki Tomiyama, Masaharu Nishimura, Nagara Tamaki
Wichtige Hinweise
Clinical trial registration: UMIN000006314, http://​www.​UMIN.​ac.​jp/​ctr/​index/​htm/​.

Abstract

Purpose

The right ventricle (RV) has a high capacity to adapt to pressure or volume overload before failing. However, the mechanisms of RV adaptation, in particular RV energetics, in patients with pulmonary hypertension (PH) are still not well understood. We aimed to evaluate RV energetics including RV oxidative metabolism, power and efficiency to adapt to increasing pressure overload in patients with PH using 11C-acetate PET.

Methods

In this prospective study, 27 patients with WHO functional class II/III PH (mean pulmonary arterial pressure 39.8 ± 13.5 mmHg) and 9 healthy individuals underwent 11C-acetate PET. 11C-acetate PET was used to simultaneously measure oxidative metabolism (k mono) for the left ventricle (LV) and RV. LV and RV efficiency were also calculated.

Results

The RV ejection fraction in PH patients was lower than in controls (p = 0.0054). There was no statistically significant difference in LV k mono (p = 0.09). In contrast, PH patients showed higher RV k mono than did controls (0.050 ± 0.009 min−1 vs. 0.030 ± 0.006 min−1, p < 0.0001). PH patients exhibited significantly increased RV power (p < 0.001) and hence increased RV efficiency compared to controls (0.40 ± 0.14 vs. 0.017 ± 0.12 mmHg·mL·min/g, p = 0.001).

Conclusion

The RV oxidative metabolic rate was increased in patients with PH. Patients with WHO functional class II/III PH also had increased RV power and efficiency. These findings may indicate a myocardial energetics adaptation response to increasing pulmonary arterial pressure.

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