title: Increased Right Ventricular Fatty Acid Accumulation in Chronic Thromboembolic Pulmonary Hypertension.
abstract: BACKGROUND
  In right ventricular hypertrophy associated with severe pulmonary hypertension (PH), a shift of energy metabolism toward glycolysis occurs. There are few investigations regarding fatty acid metabolism in patients with PH and right ventricular hypertrophy.
  
  
  OBJECTIVE
  To assess whether there is fatty acid accumulation in the hypertrophied right ventricle in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and to determine whether this accumulation is related to hemodynamic variables obtained by right heart catheterization.
  
  
  METHODS
  To assess fatty acid accumulation in the right ventricle, 123I-β-methyl iodophenyl pentadecanoic acid (BMIPP) analog imaging was performed in control subjects (n=16) and patients with CTEPH (n=13) before (n=13) and after (n=8) pulmonary thromboendarterectomy.
  
  
  RESULTS
  There was increased 123I-BMIPP uptake in the right ventricle of subjects with CTEPH before pulmonary endarterectomy. Right ventricular 123I-BMIPP uptake decreased significantly after thromboendarterectomy (P=0.003) in parallel with the change of hemodynamic variables. The right ventricular BMIPP uptake was significantly correlated with the mean pulmonary artery pressure (r=0.51, P=0.0228) but not with pulmonary vascular resistance (r=0.39, P=0.0932).
  
  
  CONCLUSIONS
  This is the first study that uses 123I-BMIPP uptake imaging to show that fatty acid accumulates in the right ventricle of patients with CTEPH and that the increased accumulation is reversible after pulmonary thromboendarterectomy. This study suggests that this imaging modality may be useful for monitoring right ventricle metabolic functions in severe PH.
authors.affiliation: 1 Department of Respirology (B2).
authors.forename: Seiichiro
authors.identifier: http://orcid.org/0000-0001-6719-1022
authors.initials: S
authors.lastname: Sakao
authors.affiliation: 2 Department of Cardiovascular Medicine, and.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Miyauchi
authors.affiliation: 3 Victoria Johnson Center for Obstructive Lung Diseases and Pulmonary and Critical Care Medicine Division, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Norbert F
authors.initials: NF
authors.lastname: Voelkel
authors.affiliation: 1 Department of Respirology (B2).
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sugiura
authors.affiliation: 4 Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan; and.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanabe
authors.affiliation: 2 Department of Cardiovascular Medicine, and.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: 1 Department of Respirology (B2).
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tatsumi
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D004691:Endarterectomy; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000378:metabolism*; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000601:surgery*; D011877:Radionuclide Imaging; D014463:Ultrasonography; D016278:Ventricular Function, Right
chemical_list: D005227:Fatty Acids; D007462:Iodobenzenes; C117025:pentadecanoic acid; C011289:2-iodophenol
keywords: 123I-β-methyl iodophenyl pentadecanoic acid; chronic thromboembolic pulmonary hypertension; fatty acid; right ventricle; thromboendarterectomy