Point-of-care β-hydroxybutyrate measurement predicts adequate glucose metabolism suppression in cardiac FDG-PET/CT

IF 1.3 4区 医学 Q4 PHYSIOLOGY
Suvi Hartikainen, Tuomo Tompuri, Tiina Laitinen, Tomi Laitinen
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引用次数: 0

Abstract

Aims

The aims of our study were to evaluate whether point-of-care β-hydroxybutyrate (BHB) measurement can be used to identify patients with adequate cardiac glucose metabolism suppression for cardiac [18F]-fluoro-2-deoxy-d-glucose-positron emission tomography with computerized tomography (FDG-PET/CT) and to develop a pretest probability calculator of myocardial suppression using other metabolic factors attainable before imaging.

Methods and Results

We recruited 193 patients with any clinical indication for whole body [18F]-FDG-PET/CT. BHB level was measured with a point-of-care device. Maximal myocardial standardized uptake value using lean body mass (SULmax) was measured from eight circular regions of interest with 1 cm circumference and background from left ventricular blood pool. Correlations SULmax and point-of-care measured BHB were analysed. The ability of BHB test to predict adequate suppression was evaluated with receiver operating characteristic analysis. Liver and spleen attenuation in computed tomography were measured to assess the presence of fatty liver. BHB level correlated with myocardial uptake and, using a cut-off value of 0.35 mmol/L to predict adequate myocardial suppression, we reached specificity of 90% and sensitivity of 56%. Other variables to predict adequate suppression were diabetes, obesity, ketogenic diet and fatty liver. Using information attainable before imaging, we created a pretest probability calculator of inadequate myocardial glucose metabolism suppression. The area under the curve for BHB test alone was 0.802 and was 0.857 for the pretest calculator (p = 0.319).

Conclusions

BHB level measured with a point-of-care device is useful in predicting adequate myocardial glucose metabolism suppression. More detailed assessment of other factors potentially contributing to cardiac metabolism is needed.

Abstract Image

护理点β-羟丁酸测量可预测心脏 FDG-PET/CT 是否能充分抑制葡萄糖代谢
目的 我们的研究旨在评估是否可以使用护理点β-羟丁酸(BHB)测量来识别心脏[18F]-氟-2-脱氧-d-葡萄糖-正电子发射计算机断层扫描(FDG-PET/CT)中有足够的心脏葡萄糖代谢抑制的患者,并使用成像前可获得的其他代谢因素来开发心肌抑制的预测概率计算器。方法和结果我们招募了 193 名具有全身 [18F]-FDG-PET/CT 任何临床指征的患者。使用床旁设备测量 BHB 水平。以瘦体重为标准的最大心肌标准化摄取值(SULmax)由八个周长为 1 厘米的圆形感兴趣区和左心室血池背景测得。分析了 SULmax 与护理点测量的 BHB 之间的相关性。通过接收器操作特征分析评估了 BHB 测试预测充分抑制的能力。通过测量计算机断层扫描中的肝脏和脾脏衰减来评估是否存在脂肪肝。BHB水平与心肌摄取量相关,以0.35毫摩尔/升为临界值预测心肌抑制是否充分,我们得出的特异性为90%,灵敏度为56%。预测充分抑制的其他变量包括糖尿病、肥胖、生酮饮食和脂肪肝。利用成像前可获得的信息,我们创建了心肌糖代谢抑制不足的测前概率计算器。结论 使用护理点设备测量的 BHB 水平有助于预测心肌糖代谢抑制是否充分。需要对可能影响心脏代谢的其他因素进行更详细的评估。
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来源期刊
CiteScore
3.40
自引率
5.60%
发文量
62
审稿时长
6-12 weeks
期刊介绍: Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.
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