肥厚性心肌病的分子成像：2-[18F]FDG和[13N]NH3的探索性研究

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Research Pub Date : 2025-02-28 DOI:10.1186/s13550-025-01212-y

Maria João Ferreira, Patrícia Marques-Alves, Rodolfo Silva, Andreia Gomes, Antero Abrunhosa, Miguel Castelo-Branco, Wael Jaber, Lino Gonçalves

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Baseline measurements included maximal myocardial wall thickness (MMWT), left atrial volume (LAV), NT-proBNP levels, and the sudden cardiac death (SCD) risk score. Increased 2-[18F]FDG uptake (Target to Background Ratio - TBR ≥ 1.1) was detected in 53% of patients, with an average TBR of 1.4 ± 0.5. The inflammatory pattern involved 11.8 ± 17.2% of the left ventricle (LV) and correlated with MMWT (rho = 0.49, p = 0.009), LAV (rho = 0.39, p = 0.04), and NT-proBNP levels (rho = 0.63, p = 0.003). The maximum TBR within the LV correlated with MMWT (rho = 0.53, p = 0.004), NT-proBNP (rho = 0.70,p = 0.0008), and the SCD risk score (rho = 0.38,p = 0.04). 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引用次数: 0

摘要

背景：肥厚性心肌病（HCM）是一种具有多种表型的遗传性疾病，与心力衰竭和心源性猝死的风险相关。虽然这种疾病涉及多种病理途径，包括心肌炎症、负荷增加、心肌细胞紊乱、细胞凋亡和纤维化，但PET-CT分子成像在这方面的作用仍未得到探索。本研究旨在利用PET-CT探讨非阻塞性HCM （NOHCM）患者心肌代谢与灌注的关系。结果：30例NOHCM患者分别采用[13N]NH3和2-[18F]FDG摄取PET-CT评估心肌灌注和代谢。基线测量包括最大心肌壁厚度（MMWT）、左房容积（LAV）、NT-proBNP水平和心源性猝死（SCD）风险评分。53%的患者检测到2-[18F]FDG摄取增加（目标与背景比- TBR≥1.1），平均TBR为1.4±0.5。炎症模式涉及左心室（LV）的11.8±17.2%，并与MMWT （rho = 0.49, p = 0.009）、LAV （rho = 0.39, p = 0.04）和NT-proBNP水平（rho = 0.63, p = 0.003）相关。LV内最大TBR与MMWT （rho = 0.53, p = 0.004）、NT-proBNP （rho = 0.70,p = 0.0008）、SCD风险评分（rho = 0.38,p = 0.04）相关。此外，纤维化（疤痕）模式，涉及左室的10.3±10.2%，与SCD评分相关（rho = 0.38,p = 0.04）。结论：在NOHCM患者中，PET-CT成像为心肌代谢和纤维化提供了有价值的信息，而心肌代谢和纤维化与心肌肥厚、左心室功能障碍以及心源性猝死的风险密切相关。

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Molecular imaging in hypertrophic cardiomyopathy: an exploratory study with 2-[¹⁸F]FDG and [¹³N]NH₃.

Background: Hypertrophic Cardiomyopathy (HCM), a genetic disorder with diverse phenotypes, is associated with risks of heart failure and sudden cardiac death. While the condition involves multiple pathological pathways, including myocardial inflammation, increased workload, myocyte disarray, apoptosis, and fibrosis, the role of molecular imaging via PET-CT remains unexplored in this context. This study aimed to investigate the relationship between myocardial metabolism and perfusion using PET-CT in patients with non-obstructive HCM (NOHCM).

Results: Myocardial perfusion and metabolism were assessed using PET-CT with [¹³N]NH3 and 2-[¹⁸F]FDG uptake, respectively, in 30 NOHCM patients. Baseline measurements included maximal myocardial wall thickness (MMWT), left atrial volume (LAV), NT-proBNP levels, and the sudden cardiac death (SCD) risk score. Increased 2-[¹⁸F]FDG uptake (Target to Background Ratio - TBR ≥ 1.1) was detected in 53% of patients, with an average TBR of 1.4 ± 0.5. The inflammatory pattern involved 11.8 ± 17.2% of the left ventricle (LV) and correlated with MMWT (rho = 0.49, p = 0.009), LAV (rho = 0.39, p = 0.04), and NT-proBNP levels (rho = 0.63, p = 0.003). The maximum TBR within the LV correlated with MMWT (rho = 0.53, p = 0.004), NT-proBNP (rho = 0.70,p = 0.0008), and the SCD risk score (rho = 0.38,p = 0.04). Additionally, the fibrotic (scar) pattern, involving 10.3 ± 10.2% of the LV, correlated with the SCD score (rho = 0.38,p = 0.04).

Conclusion: In patients with NOHCM, PET-CT imaging provides valuable insights into myocardial metabolism and fibrosis, which are closely associated with myocardial hypertrophy, left ventricular dysfunction, and the risk of sudden cardiac death.

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.