Aims: We investigated the role of metabolic alterations in the development of a maladaptive right ventricular (RV) response in pulmonary arterial hypertension (PAH), which has not previously been undertaken. This study evaluated relationships between glucose and fatty acid metabolism obtained using PET with invasive pulmonary haemodynamics, RV measurements, and RV function to gain insight into the mechanism of RV maladaptation.
Methods And Results: Seventeen consecutive PAH patients (mean age 56 ± 15) who underwent right heart catheterization [mean pulmonary arterial pressure (mPAP) 43 ± 12 mmHg] had cardiac 18F-fluoro-2-deoxyglucose (FDG) and (18)F-fluoro-6-thioheptadecanoic acid (FTHA) PET imaging. RV and left ventricular (LV) FDG and FTHA uptake standard uptake values (SUVs) were measured. The SUV was corrected for the partial volume effect (SUV) based on cardiac magnetic resonance imaging (CMR). Right ventricular ejection fraction (RVEF) was determined by CMR. There was a significant positive correlation between mPAP and RV/LV FDG SUV (r = 0.68, P = 0.003), and the ratio of RV/LV FDG SUV : RV/LV FTHA SUV (r = 0.60, P = 0.02). RVEF was negatively correlated with RV/LV FDG SUV uptake (r = -0.56, P = 0.02) and RV/LV FTHA SUV (r = -0.62, P = 0.019).
Conclusion: Increased pulmonary arterial pressures are associated with increases in the ratio of FDG/FTHA uptake in the RV. Inverse correlation between the uptake of the metabolic tracers and RV function may reflect a shift towards increased fatty acid oxidation and glycolysis associated with RV failure in maladaptive remodelling.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ehjci/jev136 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Recurrent Cardiac Tamponade by Pulmonary Artery Intimal Sarcoma.
Echocardiography
January 2025
Department of Hospitalization, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico.
A 43-year-old woman presented with dyspnea and cough, initially misdiagnosed as respiratory syncytial virus. Persistent symptoms led to pulmonary thromboembolism treatment, but worsening issues revealed recurrent pericardial effusion. Imaging and biopsy confirmed pulmonary artery intimal sarcoma, mimicking thromboembolism, and autoimmune disease, underscoring diagnostic challenges.
View Article and Find Full Text PDFGuidelines recommend risk stratification of pulmonary arterial hypertension (PAH) patients to guide management. There are currently several risk stratification scores available, which have largely been validated in various pulmonary hypertension registries in the West but not in Asia. We aim to study the performance of these different risk scores in PAH patients from a multi-ethnic Asian population.
View Article and Find Full Text PDFEarly Patient Outcome and Left Ventricular Function After Mitral Valve Replacement Using a Tilting Disc Mechanical Valve With Total Preservation of Mitral Valvular Apparatus.
Cureus
November 2024
Internal Medicine, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, IND.
Introduction The study aimed to retrospectively evaluate the early patient outcome and left ventricular function after mitral valve replacement with a tilting disc valve and total preservation. Patients and methods This retrospective observational study includes patients who underwent mitral valve replacement using a tilting disc valve with total preservation of mitral valvular and subvalvular apparatus from July 2021 to August 2022 at a single center. Results The data were reviewed retrospectively for age, sex, comorbidities, operating time, aortic cross-clamp time, cardiopulmonary bypass time, preoperative and postoperative left ventricular ejection fraction, mean gradient across the mitral valve, left ventricular diameter, left atrial size, atrial fibrillation, complications, mortality, and early patient outcome.
View Article and Find Full Text PDFProteomics-Based Soluble Urokinase Plasminogen Activator Receptor Levels Are Associated With Incident Heart Failure Risk.
JACC Adv
January 2025
Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta, Georgia, USA.
Background: Higher soluble urokinase plasminogen activator receptor (suPAR) levels are associated with adverse outcomes in chronic heart failure (HF).
Objectives: The authors assessed the association between proteomics-based suPAR levels and incident HF risk in the general population.
Methods: In 40,418 UK Biobank participants without HF or coronary artery disease at enrollment, the association between Olink-based suPAR levels measured as relative protein expression levels and incident all-cause, ischemic, and nonischemic HF was analyzed by competing-risk regression, while accounting for all-cause death as a competing risk.
Right ventricular stroke work index from echocardiography in patients with pulmonary arterial hypertension-the role in short-term follow-up assessment.
Eur Heart J Imaging Methods Pract
July 2024
Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Entrégatan, Lund 221 85, Sweden.
Aims: Right ventricular (RV) failure causes high mortality in patients with pulmonary arterial hypertension (PAH). RV stroke work index (RVSWi) poses as a potential predictor of outcome. We evaluated how RVSWi by echocardiography (ECHO) or right heart catheterization (RHC) is altered following PAH treatment and if RVSWi is an indicator of outcome in PAH.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!