Imaging of cardiac sympathetic dysfunction with 18F-FDOPA PET/CT in patients with heart failure: a pilot study.

Autor: Thanigainathan T; Department of Nuclear Medicine, AIIMS, New Delhi, India., Sharma A; Department of Nuclear Medicine, HBCHRC (Tata Memorial Centre), Mullanpur, Punjab, India., Patel C; Department of Nuclear Medicine, AIIMS, New Delhi, India. cdpatel09@gmail.com., Seth S; Department of Cardiology, AIIMS, New Delhi, India., Roy A; Department of Cardiology, AIIMS, New Delhi, India., Pandey AK; Department of Nuclear Medicine, AIIMS, New Delhi, India., Gupta P; Department of Nuclear Medicine, AIIMS, New Delhi, India., Kumar R; Department of Nuclear Medicine, AIIMS, New Delhi, India., Kumar P; Department of Nuclear Medicine, AIIMS, New Delhi, India., Bal CS; Department of Nuclear Medicine, AIIMS, New Delhi, India.
Jazyk: angličtina
Zdroj: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2023 Jun; Vol. 30 (3), pp. 1147-1157. Date of Electronic Publication: 2022 Dec 06.
DOI: 10.1007/s12350-022-03150-x
Abstrakt: Background: Routine use of cardiac sympathetic imaging in HF has been limited by the lower availability/sensitivity of radiotracers. This study was aimed to assess the feasibility of 18F-FDOPA (commonly available PET-radiotracer) in assessment of cardiac autonomic dysfunction.
Methods: Twenty-four controls (46.5 ± 11.1 years, 16men) and 24 patients (43.5 ± 11.0 years, 18men) with diagnosed HF (Framingham-Criteria) underwent cardiac-PET/CT. Region(s) Of Interest were drawn over entire left ventricular myocardium (LV), individual walls, and mediastinum (M). Coefficient of Variation (CV) was calculated from individual wall counts.
Results: HF patients had significantly lower myocardial 18F-FDOPA uptake (P < .001, independent t test) than controls [32.4% ± 9.5% global reduction; highest in apex (39.9% ± 7.0%)]. A cut-off of LV/M ≤ 1.68 could differentiate patients from controls with sensitivity and specificity of 100% and 95.8%, respectively. LV/M correlated positively with EF (Pearson coefficient = 0.460, P .031). During follow-up, 3 patients were lost to follow-up, 4 died (survival-20.5 ± 4 months), 2 worsened, and 15 remained stable/showed mild improvement. Patients who worsened/died during follow-up had higher CV than those with stable/improving symptoms [0.16 ± 0.05 vs 0.11 ± 0.05, P value .069 (independent t test); Cox regression P = .084].
Conclusion: Myocardial 18F-FDOPA uptake in patients with HF is significantly reduced. Higher reduction is seen in those with lower EF. CV, a maker of regional heterogeneity, is a potential prognostic marker.
(© 2022. The Author(s) under exclusive licence to American Society of Nuclear Cardiology.)
Databáze: MEDLINE
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