title: Enhanced [18F]fluorodeoxyglucose accumulation in the right ventricular free wall predicts long-term prognosis of patients with pulmonary hypertension: a preliminary observational study.
abstract: OBJECTIVE
  We have previously demonstrated that [(18)F]fluorodeoxyglucose (FDG) accumulation is increased in the right ventricular (RV) free wall of patients with pulmonary hypertension (PH), and that this accumulation is ameliorated after the treatment with epoprostenol associated with improvement of haemodynamic overload. The aim of this study was to examine whether enhanced RV FDG accumulation by gated positron emission tomography (PET) has a prognostic impact in patients with PH.
  
  
  RESULTS
  We examined the prognostic impact of the RV standardized uptake value (SUV) of FDG-PET corrected for the partial volume effect (cRV-SUV) in 27 patients with PH who underwent gated FDG-PET from March 2001 to June 2004. During the follow-up period of 69 ± 49 (mean ± SD) months, among the 27 patients, 15 showed clinical worsening (CW) and 11 died. FDG-PET examination showed that cRV-SUV was significantly higher in the CW group compared with the non-CW group (10.1 vs. 7.6, P = 0.02). Univariate Cox hazard analysis showed that cRV-SUV was significantly correlated with the time to CW (hazard ratio 1.25, 95% confidence interval 1.04-1.51, P = 0.02), which remained significant even after adjustment of World Health Organization functional class. Kaplan-Meier analysis showed that the patients with cRV-SUV ≥8.3 had poor prognosis compared with those with cRV-SUV <8.3 (log-rank P = 0.005 for time to CW and P = 0.07 for mortality).
  
  
  CONCLUSIONS
  These results indicate that enhanced FDG accumulation in the RV free wall may be a novel prognostic factor in patients with PH.
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tatebe
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan fukumoto@cardio.med.tohoku.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fukumoto
authors.affiliation: Department of Cardiology, Japanese Red Cross Sendai Hospital, Sendai, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Oikawa-Wakayama
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Sugimura
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Kimio
authors.initials: K
authors.lastname: Satoh
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Aoki
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Nochioka
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Miura
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Cyclotron and Radioisotope Centre, Tohoku University, Sendai, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Tashiro
authors.affiliation: Comprehensive Education Centre for Community Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kagaya
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D019788:Fluorodeoxyglucose F18; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000401:mortality; D007089:Image Enhancement / Q000379:methods; D053208:Kaplan-Meier Estimate; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Fluorodeoxyglucose; Myocardial energy substrate metabolism; Positron emission tomography; Prognosis; Pulmonary hypertension