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The Ratio of 18F-FDG Activity Uptake Between the Right and Left Ventricle in Patients With Pulmonary Hypertension Correlates With the Right Ventricular Function

Yang, Tao MD; Wang, Lei MD; Xiong, Chang-Ming MD; He, Jian-Guo MD; Zhang, Yan MD; Gu, Qing MD; Zhao, Zhi-hui MD; Ni, Xin-Hai MD; Fang, Wei MD; Liu, Zhi-Hong MD

doi: 10.1097/RLU.0000000000000422
Original Articles

Purpose: It is known that patients with pulmonary hypertension (PH) can have elevated 18F-FDG uptake in the right ventricle (RV) on PET imaging. This study was designed to assess possible relationship between FDG uptake of ventricles and the function/hemodynamics of the RV in patients with PH.

Patients and Methods: Thirty-eight patients with PH underwent FDG PET imaging in both fasting and glucose-loading conditions. The standard uptake value (SUVs) corrected for partial volume effect in both RV and left ventricle (LV) were measured. The ratio of FDG uptake between RV to LV (SUVR/L) was calculated. Right heart catheterization and cardiac magnetic resonance (CMR) were performed in all patients within 1 week. The FDG uptake levels by the ventricles were compared with the result form the right heart catheterization and CMR.

Results: The SUV of RV (SUVR) and SUV of LV were significantly higher in glucose-loading condition than in fasting condition. In both fasting and glucose-loading conditions, SUVR and SUVR/L showed reverse correlation with right ventricular ejection fraction derived from CMR. In addition, in both fasting and glucose-loading conditions, SUVR and SUVR/L showed positive correlations with pulmonary vascular resistance. However, only SUVR/L in glucose-loading condition could independently predict right ventricular ejection fraction after adjusted for age, body mass index, sex, mean right atrial pressure, mean pulmonary arterial pressure, and pulmonary vascular resistance (P = 0.048).

Conclusions: The FDG uptake of RV increases with decreased right ventricular function in patients with PH. Increased FDG uptake ratio between RV and LV might be useful to assess the right ventricular function.

From the State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China.

Received for publication December 15, 2013; revision accepted January 28, 2014.

Tao Yang and Lei Wang contributed equally as first authors to this study.

Conflicts of interest and sources of funding: National Key Technology R&D Program, China (project number: 2011BAI11B15); Science and Technology Project of Beijing, China (project number: Z099597017709032); and Capital Medical Scientific Development Fund, Beijing, China (project number: 2009-1003).

Reprints: Jian-Guo He, MD, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Rd, Xicheng Direct, Beijing, 100037, People’s Republic of China. E-mail: hejianguofw@163.com; Chang-Ming Xiong, MD, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Rd, Xicheng Direct, Beijing, 100037, People’s Republic of China. E-mail: xiongcm2000@126.com.

© 2014 by Lippincott Williams & Wilkins