Increased [18F]fluorodeoxyglucose accumulation in right ventricular free wall in patients with pulmonary hypertension and the effect of epoprostenol.
OBJECTIVE
We examined whether right ventricular (RV) [(18)F]fluorodeoxyglucose (FDG) accumulation is increased in patients with pulmonary hypertension using gated positron emission tomography (PET) and whether RV FDG accumulation changes after therapy with epoprostenol.


BACKGROUND
Myocardial glucose utilization is increased in animal models with ventricular pressure overload.


METHODS
We performed gated FDG-PET in 24 patients with pulmonary hypertension. The RV standardized uptake value (SUV) of FDG was corrected for the partial volume effect based on the wall thickness measured by electron-beam computed tomography or magnetic resonance imaging.


RESULTS
The corrected RV SUV of FDG was significantly correlated with the pulmonary vascular resistance, mean pulmonary artery pressure, right atrial pressure, RV wall stress, and plasma brain natriuretic peptide levels, but not with the RV wall thickness and mass. After pulmonary vasodilator therapy with epoprostenol for three months, the corrected RV SUV of FDG significantly decreased in the responders, but not in the non-responders, and the percentage change of the corrected RV SUV of FDG was significantly correlated with the percentage change of the pulmonary vascular resistance (r = 0.78; p < 0.01) and RV systolic wall stress (r = 0.76; p < 0.05).


CONCLUSIONS
The RV FDG accumulation corrected for the partial volume effect was significantly increased in accordance with the severity of the RV pressure overload (i.e., the RV peak-systolic wall stress) in patients with pulmonary hypertension. Furthermore, the corrected RV FDG accumulation was decreased after the treatment with epoprostenol in accordance with the degree of reduction in the pulmonary vascular resistance and RV peak-systolic wall stress.
Oikawa
Minako
M
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kagaya
Yutaka
Y
Otani
Hiroki
H
Sakuma
Masahito
M
Demachi
Jun
J
Suzuki
Jun
J
Takahashi
Tohru
T
Nawata
Jun
J
Ido
Tatsuo
T
Watanabe
Jun
J
Shirato
Kunio
K
D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D011464:Epoprostenol / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006352:Heart Ventricles / Q000378:metabolism*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D013318:Stroke Volume; D014655:Vascular Resistance / Q000187:drug effects; D017725:Ventricular Pressure
D000959:Antihypertensive Agents; D019788:Fluorodeoxyglucose F18; D011464:Epoprostenol