Atrial FDG uptake and atrial fibrillation: A systematic review and meta-analysis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Rhythm O2 Pub Date : 2025-04-01 DOI:10.1016/j.hroo.2025.01.002

Ahmad Kassar MD , Nadia Chamoun MD , Romanos Haykal MD , Yaacoub Chahine MD , Miles Babb MD , Hala Al Yasiri MD , Tori Hensley BSc , Efstathia Andrikopoulou MD , Nazem Akoum MD, MS

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Abstract

Background

Atrial inflammatory and metabolic derangements have been reported in patients with atrial fibrillation (AF).

Objective

We sought to evaluate the association of ¹⁸F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) in the left and right atria and AF.

Methods

We conducted a systematic review and meta-analysis, using the PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, of studies involving patients undergoing FDG-PET scans with reported atrial or ventricular uptake and outcomes of AF. Data were pooled and analyzed, and FDG uptake in AF and non-AF patients was compared using odds ratios (ORs).

Results

Six studies (4 retrospective, 1 prospective, and 1 case-control) were included in the meta-analysis of studies on patients not meeting diagnostic criteria for cardiac sarcoidosis (CS): 832 patients with a mean age of 67 years, 62% male, and 53% with hypertension. AF patients demonstrated higher odds of FDG uptake in the left atrium (pooled OR 14.50, 95% confidence interval 6.78–31.02; P < .0001, I² = 0) and right atrium (pooled OR 51.98, 95% confidence interval 22.77–118.63, P < .0001, I² = 0). Two studies on patients met diagnostic criteria for CS: one did not report atrial uptake and the other did not demonstrate a statistically significant association between right or left atrial uptake in AF patients.

Conclusion

In patients undergoing FDG-PET without meeting CS diagnostic criteria, FDG uptake in the atria was strongly associated with AF, suggesting altered metabolism or inflammation in AF pathophysiology and risk assessment.

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心房FDG摄取与心房颤动：系统回顾和荟萃分析

背景：心房颤动（AF）患者有炎症和代谢紊乱的报道。目的：我们试图评估正电子发射断层扫描（PET）左心房和右心房的18f -氟脱氧葡萄糖（FDG）摄取与房颤的关系。方法：我们使用PRISMA系统评价和荟萃分析首选报告项目（Preferred Reporting Items for systematic Reviews and meta-analysis）指南，对接受FDG-PET扫描的报告心房或心室摄取和房颤结局的患者进行了系统回顾和荟萃分析。使用优势比（ORs）比较房颤和非房颤患者的FDG摄取。结果6项研究（4项回顾性研究，1项前瞻性研究，1项病例对照研究）纳入了不符合心脏结节病（CS）诊断标准的研究荟萃分析：832例患者，平均年龄67岁，62%为男性，53%患有高血压。AF患者在左心房摄取FDG的几率更高(合并OR为14.50,95%可信区间为6.78-31.02；P & lt;0.0001, I2 = 0)和右心房(合并OR为51.98,95%可信区间为22.77-118.63,P <；.0001, I2 = 0)。两项患者的研究符合CS的诊断标准：一项研究未报道心房摄取，另一项研究未显示房颤患者的左心房摄取与右心房摄取有统计学意义的关联。结论在不符合CS诊断标准的FDG- pet患者中，心房FDG摄取与房颤密切相关，提示房颤病理生理和风险评估中的代谢或炎症改变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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