title: Routine18F-FDG PET/CT does not detect inflammation in the left atrium in patients with atrial fibrillation.
abstract: Increasing evidence supports a role of inflammation in the development of atrial fibrillation (AF). However, direct evidence of persistent inflammatory activity in the atria of AF patients is scarce. In this study, we used 18-Fluor-Deoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT) to determine atrial inflammation in patients with and without AF. Retrospectively,18F-FDG PET/CT scans were analyzed. 37 patients with a history of AF were compared to an age and sex matched control group with no history of AF. Standardized uptake values were obtained in the atrial walls, in the left ventricular wall, and in the right ventricular blood pool, respectively. Target to background ratios (TBR) were determined in the atrial and left ventricular walls and compared between the two groups. TBR values of the left atrial wall were slightly but not significantly higher in patients with AF (1.21 ± 0.27) compared to those without AF (1.14 ± 0.29; p = 0.85). Likewise, a weak but not significant difference was observed in signal intensities in the right atrial wall between patients in the AF (1.14 ± 0.45) and the control group (0.96 ± 0.2; p = 0.41). TBR values of the left ventricular myocardium did not differ between the groups; no significant correlation was found between the TBR in the left and right atrial wall and blood glucose levels.18F-FDG PET/CT performed under routine conditions did not detect a significant difference in inflammatory activity in the left or right atrium between patients with and without AF. Contrary to previous reports, these results therefore do not clearly support a role for ongoing atrial inflammation in patients with AF. Prospective clinical studies using myocardial glucose uptake suppression strategies may be helpful to clarify these issues.
authors.affiliation: Division of Clinical and Experimental Rhythmology, Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany. PhilippSebastian.Lange@ukmuenster.de.|Sonderforschungsbereich 656, Münster, Germany. PhilippSebastian.Lange@ukmuenster.de.
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Lange
authors.affiliation: Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Nemanja
authors.initials: N
authors.lastname: Avramovic
authors.affiliation: Division of Clinical and Experimental Rhythmology, Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.
authors.forename: Gerrit
authors.initials: G
authors.lastname: Frommeyer
authors.affiliation: Division of Clinical and Experimental Rhythmology, Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Wasmer
authors.affiliation: Division of Clinical and Experimental Rhythmology, Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Pott
authors.affiliation: Division of Clinical and Experimental Rhythmology, Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.|Sonderforschungsbereich 656, Münster, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
authors.affiliation: Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.|Sonderforschungsbereich 656, Münster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wenning
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Atrial fibrillation; Cardiac imaging; Inflammation; Positron emission tomography