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Association of Right Ventricular Myocardial Blood Flow With Pulmonary Pressures and Outcome in Cardiac Amyloidosis

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Název: Association of Right Ventricular Myocardial Blood Flow With Pulmonary Pressures and Outcome in Cardiac Amyloidosis
Autoři: Hendrik J. Harms, Tor Clemmensen, Sara Rosengren, Lars Tolbod, Björn Pilebro, Gerhard Wikström, Sven-Olof Granstam, Tanja Kero, Marcelo Di Carli, Steen Hvitfeldt Poulsen, Jens Sorensen
Zdroj: Harms, H J, Clemmensen, T, Rosengren, S, Tolbod, L, Pilebro, B, Wikström, G, Granstam, S-O, Kero, T, Di Carli, M, Poulsen, S H & Sorensen, J 2023, 'Association of Right Ventricular Myocardial Blood Flow With pulmonary Pressures and Outcome in Cardiac Amyloidosis', JACC: Cardiovascular Imaging, vol. 16, no. 9, pp. 1193-1204. https://doi.org/10.1016/j.jcmg.2023.01.024
Informace o vydavateli: Elsevier BV, 2023.
Rok vydání: 2023
Témata: Heart Failure, positron emission tomography, Ventricular Dysfunction, Right, Heart Ventricles, cardiac amyloidosis, Amyloidosis, right ventricle, Heart Ventricles/diagnostic imaging, myocardial blood flow, 3. Good health, Predictive Value of Tests, Echocardiography, pulmonary hypertension, Humans, Tomography, X-Ray Computed, Ventricular Dysfunction, Right/diagnostic imaging
Popis: Cardiac amyloidosis (CA) is a restrictive and infiltrative cardiomyopathy, characterized by increased biventricular filling pressures and low output. Symptoms are predominantly of right heart origin. The role of right ventricular (RV) myocardial blood flow (MBF) in CA has not been studied.This study aimed to first associate RV MBF measured by using positron emission tomography (PET) with reference standards of RV pressures and then to explore its prognostic value in CA.Cardiac PET was performed at rest in 52 patients with CA and 9 healthy control subjects. MBF was quantified from the right and left ventricles by using 11C-acetate, 15O-water, or both (n = 25). RV pressure was measured invasively or by echocardiography. Associations between biventricular MBF toward symptoms, RV function, and outcome (death or acute heart failure) were studied in patients with CA.MBF of the right ventricle (MBFRV) and the ratio of MBFRV and MBF of the left ventricle (MBFRV/LV) for the 2 tracers were significantly correlated (r > 0.92). MBFRV was directly correlated with RV systolic pressures with both tracers (P ≤ 0.005). MBFLV was inversely correlated with wall thickness (P < 0.0001). MBFRV/LV was significantly associated with N-terminal pro-B-type natriuretic peptide levels, NYHA functional class, RV pressures, and RV systolic function (all; P < 0.001). Twenty-six cardiac events (25 deaths) occurred during follow-up (median 44 months). MBFRV/LV higher than 56% was associated with a diagnosis of pulmonary hypertension (AUC: 0.96 [95% CI: 0.91-1.00]; P
Druh dokumentu: Article
Jazyk: English
ISSN: 1936-878X
DOI: 10.1016/j.jcmg.2023.01.024
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/37052560
Rights: Elsevier Non-Commercial
Přístupové číslo: edsair.doi.dedup.....c443c54c8bf64b2e9dd708b6be14e08c
Databáze: OpenAIRE
Popis
Abstrakt:Cardiac amyloidosis (CA) is a restrictive and infiltrative cardiomyopathy, characterized by increased biventricular filling pressures and low output. Symptoms are predominantly of right heart origin. The role of right ventricular (RV) myocardial blood flow (MBF) in CA has not been studied.This study aimed to first associate RV MBF measured by using positron emission tomography (PET) with reference standards of RV pressures and then to explore its prognostic value in CA.Cardiac PET was performed at rest in 52 patients with CA and 9 healthy control subjects. MBF was quantified from the right and left ventricles by using 11C-acetate, 15O-water, or both (n = 25). RV pressure was measured invasively or by echocardiography. Associations between biventricular MBF toward symptoms, RV function, and outcome (death or acute heart failure) were studied in patients with CA.MBF of the right ventricle (MBFRV) and the ratio of MBFRV and MBF of the left ventricle (MBFRV/LV) for the 2 tracers were significantly correlated (r > 0.92). MBFRV was directly correlated with RV systolic pressures with both tracers (P ≤ 0.005). MBFLV was inversely correlated with wall thickness (P < 0.0001). MBFRV/LV was significantly associated with N-terminal pro-B-type natriuretic peptide levels, NYHA functional class, RV pressures, and RV systolic function (all; P < 0.001). Twenty-six cardiac events (25 deaths) occurred during follow-up (median 44 months). MBFRV/LV higher than 56% was associated with a diagnosis of pulmonary hypertension (AUC: 0.96 [95% CI: 0.91-1.00]; P
ISSN:1936878X
DOI:10.1016/j.jcmg.2023.01.024