Right ventricular sugars and fats in chronic thromboembolic pulmonary hypertension.
OBJECTIVE
Several studies have already shown the correlation between the right ventricle (RV) hemodynamic values and either glucose uptake or fatty acid uptake in the RV, respectively. However, there are few studies to compare the RV metabolic alteration before and after treatment for pulmonary hypertension. The aims of this study are to assess right ventricular glucose and fatty acid in chronic thromboembolic pulmonary hypertension (CTEPH) patients before and after pulmonary thromboendarterectomy and to examine whether there is a correlation between right ventricular glucose and fatty acid uptake.


METHODS
To assess glucose and fatty acid accumulation in the RV, [(18)F] fluoro-2-deoxyglucose (FDG)-positron emission tomography (PET) and (123)I-β-methyl iodophenyl pentadecanoic acid (BMIPP) imaging were performed in CTEPH patients before (FDG: n=20, BMIPP: n=13) and after (FDG: n=12, BMIPP: n=8) thromboendarterectomy.


RESULTS
Both [(18)F] FDG uptake and (123)I-BMIPP uptake in RV of post-PEA patients obviously decreased after this operation procedure (p<0.01). The right ventricle [(18)F] FDG uptake was also significantly correlated with (123)I-BMIPP uptake (r=0.45, p=0.04).


CONCLUSIONS
In this study, we observed that both glucose and fatty acid accumulated in the RV of patients with CTEPH. Although the exact details of the altered energy metabolism in the stressed RV remain unknown, this is the first study to evaluate both glucose and fatty acid uptake before and after thromboendarterectomy in patients with CTEPH, even though the number of the patient is limited.
Department of Respirology (B2), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: sakaos@faculty.chiba-u.jp.
Seiichiro
S
Sakao
Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: miko0122@kkd.biglobe.ne.jp.
Michiko
M
Daimon
Victoria Johnson Center for Obstructive Lung Diseases and Pulmonary and Critical Care Medicine Division, Virginia Commonwealth University, Molecular Medicine and Research Building, Richmond, VA 23298-0456, USA. Electronic address: nfvoelkel@gmail.com.
Norbert F
NF
Voelkel
Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: hmiyauchi_circ@yahoo.co.jp.
Hideyuki
H
Miyauchi
Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: naikamo_resp19184@yahoo.co.jp.
Takayuki
T
Jujo
Department of Respirology (B2), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: sugiura@js3.so-net.ne.jp.
Toshihiko
T
Sugiura
Department of Cardiovascular Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: keiichi-ishida@pro.odn.ne.jp.
Keiichi
K
Ishida
Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: ntanabe@faculty.chiba-u.jp.
Nobuhiro
N
Tanabe
Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: yuiryosuke@msn.com.
Yoshio
Y
Kobayashi
Department of Respirology (B2), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: tatsumi@faculty.chiba-u.jp.
Koichiro
K
Tatsumi
D000328:Adult; D000368:Aged; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000378:metabolism*
D005227:Fatty Acids; D019788:Fluorodeoxyglucose F18; D005947:Glucose
Fatty acid oxidation; Glucose oxidation; Glycolysis; Pulmonary hypertension; Right ventricle