急性心肌炎后4至5个月炎症细胞持续生长抑素PET体征与心功能较差的恢复有关

IF 8.6 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Thomas Larive, Caroline Boursier, Marine Claudin, Jeanne Varlot, Laura Filippetti, Olivier Huttin, Véronique Roch, Laetitia Imbert, Matthieu Doyen, Antoine Fraix, Damien Mandry, Elodie Chevalier, Pierre-Yves Marie
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引用次数: 0

摘要

目的急性心肌炎(AM)最近被发现可以通过生长抑素正电子发射断层扫描(PET)标准检测到18 cm3心肌摄取体积(MUV),这是明显的炎症细胞浸润的标志。这项研究的特点是患者的这一标准持续4至5个月后AM。方法分析27例AM患者(2例女性,中位年龄26.5岁[四分位数范围:21.9 ~ 31.9])急性期和4.5[4.3 ~ 5.0]个月随访期间的心脏磁共振(CMR)和[68 Ga]Ga- dota - toc PET数据。结果7例AM患者(41%)随访时仍有18 cm3 MUV (PET +)。左室射血分数(LVEF)在基线(p = 0.011)和随访(p = 0.001)时与MUV相关,PET +组随访时较低(52.9 [48.6;55.0] %)高于其他患者(56.0 [54.3;57.8] %, p = 0.001)。然而,PET + LVEF较差的恢复与两种不同机制的MUV进化谱有关:(i)随访时MUV升高的5例PET +患者的活动性疾病延长,与LVEF的轻微下降相关(p = 0.08); (ii)随访时MUV降低的另外6例PET +患者的初始损伤更严重,LVEF同时升高(p = 0.028),但这些改善始于更差的基线LVEF和MUV(分别p = 0.022和0.003)。结论AM的生长抑素PET监测揭示了许多急性心肌炎后4至5个月持续炎症细胞浸润的迹象。这种持续性与心功能较差的恢复有关,似乎是由于活动性炎症在基线时更严重或在接下来的几个月内继续扩大。临床试验注册号:NCT03347760。报名日期:2017年11月22日
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Persistent somatostatin PET signs of inflammatory cells 4 to 5 months after acute myocarditis are linked to a poorer recovery of cardiac function

Purpose

Acute Myocarditis (AM) was recently shown to be detected by the Somatostatin Positron Emission Tomography (PET) criterion of > 18 cm3 Myocardial Uptake Volume (MUV), a sign of significant inflammatory cell infiltration. This study characterizes patients for whom this criterion persists 4 to 5 months after AM.

Methods

Cardiac Magnetic Resonance (CMR) and [68 Ga]Ga-DOTA-TOC PET data from 27 AM patients (2 women, median age 26.5 years [interquartile range: 21.9–31.9]) were analyzed at the acute phase and at a 4.5 [4.3–5.0] month follow-up.

Results

Eleven AM patients (41%) still had > 18 cm3 MUV at the follow-up (PET +). The left ventricular ejection fraction (LVEF) was correlated with MUV at baseline (p = 0.011) and follow-up (p = 0.001) and was lower at follow-up in PET + (52.9 [48.6; 55.0] %) than in the other patients (56.0 [54.3; 57.8] %, p = 0.001). However, this poorer recovery of the PET + LVEF was associated with two MUV evolution profiles evocative of different mechanisms: (i) a prolonged active disease in the 5 PET + patients for whom the MUV increased at follow-up, in association with a slight decrease in LVEF (p = 0.08), and (ii) a more severe initial insult in the 6 other PET + patients for whom the MUV decreased at follow-up with concomitant increases in LVEF (p = 0.028) but these improvements started from much worse baseline LVEF and MUV (respectively, p = 0.022 and 0.003 vs. the other patients).

Conclusions

Somatostatin PET monitoring of AM unveils numerous patients with signs of a persistent inflammatory cell infiltrate 4 to 5 months after acute myocarditis. This persistence is associated with poorer recovery of cardiac function and is seemingly due to active inflammation that is either more severe at baseline or continues to expand over the following months.

Trial registration number: NCT03347760 on clinicaltrials.gov.

Registration date: 22–11-2017.

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来源期刊
CiteScore
15.60
自引率
9.90%
发文量
392
审稿时长
3 months
期刊介绍: The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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