title: Quantitative assessment of right ventricular glucose metabolism in idiopathic pulmonary arterial hypertension patients: a longitudinal study.
abstract: OBJECTIVE
  Right ventricular (RV) glucose metabolism disorder in pulmonary arterial hypertension (PAH) has been studied using (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging with inconsistent results. We aimed to quantitatively assess RV glucose metabolism and further identify its role of monitoring RV function in idiopathic PAH (IPAH) patients in a longitudinal study.
  
  
  RESULTS
  Twenty-seven treatment-naïve IPAH patients and 21 healthy control subjects performed FDG-PET dynamic scan for quantification of the rate of myocardium glucose utilization (rMGU) and echocardiography for assessment of cardiac function. Right heart catheterization was conducted for IPAH patients for haemodynamic measurement. A subgroup of 14 patients repeated FDG-PET and echocardiography after 6-month treatment. RV rMGU was significantly increased compared with controls; while the rMGU in left ventricle showed no difference. RV rMGU was significantly correlated with pulmonary artery pressure, pulmonary vascular resistance, RV Tei index, and right atrial area, and negatively correlated with RV ejection fraction (RVEF) and tricuspid annular plane systolic excursion. Six of 14 patients with increased RV rMGU after 6-month treatment showed no change in RVEF, 6-min walk distance (6MWD), and RV Tei index; however, the other 8 patients with decreased RV rMGU demonstrated significantly increased RVEF and 6MWD and decreased RV Tei index. Notably, the change in RV rMGU of 14 patients was significantly correlated with the change in 6MWD and RV Tei index.
  
  
  CONCLUSIONS
  Increased RV rMGU of IPAH correlates with RV dysfunction and RV pressure overload. The change in RV glucose metabolism may help monitor RV function after treatment.
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China Centre for Pharmacology and Therapeutics, Experimental Medicine, Imperial College London, London, UK.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Center for Diagnosis and Management of Pulmonary Vascular Diseases, Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Echocardiography, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Weichun
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Echocardiography, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Qizhe
authors.initials: Q
authors.lastname: Cai
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China.
authors.forename: Xinghong
authors.initials: X
authors.lastname: Ma
authors.affiliation: Center for Diagnosis and Management of Pulmonary Vascular Diseases, Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Changming
authors.initials: C
authors.lastname: Xiong
authors.affiliation: Center for Diagnosis and Management of Pulmonary Vascular Diseases, Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China nuclearfw@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods; D005069:Evaluation Studies as Topic; D017079:Exercise Tolerance / Q000502:physiology*; D065627:Familial Primary Pulmonary Hypertension / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000502:physiology*
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose
keywords: FDG-PET; myocardial glucose metabolism; pulmonary arterial hypertension; right ventricle