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Attenuated right ventricular energetics evaluated using 11C-acetate PET in patients with pulmonary hypertension

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The right ventricle (RV) has a high capacity to adapt to pressure or volume overload before failing. However, the mechanisms of RV adaptation, in particular RV energetics, in patients with pulmonary hypertension (PH) are still not well understood. We aimed to evaluate RV energetics including RV oxidative metabolism, power and efficiency to adapt to increasing pressure overload in patients with PH using 11C-acetate PET.

Methods

In this prospective study, 27 patients with WHO functional class II/III PH (mean pulmonary arterial pressure 39.8 ± 13.5 mmHg) and 9 healthy individuals underwent 11C-acetate PET. 11C-acetate PET was used to simultaneously measure oxidative metabolism (k mono) for the left ventricle (LV) and RV. LV and RV efficiency were also calculated.

Results

The RV ejection fraction in PH patients was lower than in controls (p = 0.0054). There was no statistically significant difference in LV k mono (p = 0.09). In contrast, PH patients showed higher RV k mono than did controls (0.050 ± 0.009 min−1 vs. 0.030 ± 0.006 min−1, p < 0.0001). PH patients exhibited significantly increased RV power (p < 0.001) and hence increased RV efficiency compared to controls (0.40 ± 0.14 vs. 0.017 ± 0.12 mmHg·mL·min/g, p = 0.001).

Conclusion

The RV oxidative metabolic rate was increased in patients with PH. Patients with WHO functional class II/III PH also had increased RV power and efficiency. These findings may indicate a myocardial energetics adaptation response to increasing pulmonary arterial pressure.

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Acknowledgments

The authors thank Keiichi Magota, PhD, Hidehiko Omote, RT, Ken-ichi Nishijima, PhD, Daiske Abo, MSc, Kumi Ajiki, and Eriko Suzuki for their support during this study.

This study was supported in part by grants from the Japanese Ministry of Education, Science and Culture (category B, no. 23390294), the Hokkaido Heart Association (H-20; Sapporo, Japan), the Adult Vascular Disease Research Foundation (H22-23; Kyoto, Japan), and the North-Tech Research Foundation (H23-S2-17; Sapporo, Japan). Dr. Yoshinaga is supported by an Imura Clinical Research Award (Adult Vascular Disease Research Foundation).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, Japan, 060-8638

    Keiichiro Yoshinaga

  2. First Department of Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Hiroshi Ohira, Ichizo Tsujino, Takahiro Sato & Masaharu Nishimura

  3. Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan

    Noriko Oyama-Manabe

  4. Division of Cardiology, Ottawa Heart Institute, Ottawa, Ontario, Canada

    Lisa Mielniczuk & Rob S. B. Beanlands

  5. Faculty of Health Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Chietsugu Katoh & Katsuhiko Kasai

  6. Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Osamu Manabe, Yuuki Tomiyama & Nagara Tamaki

  7. Nagoya City University Graduate School of Pharmaceutical Sciences, Nagoya, Japan

    Satoshi Fujii

  8. Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yoichi M. Ito

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  1. Keiichiro Yoshinaga
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Correspondence to Keiichiro Yoshinaga.

Additional information

Clinical trial registration: UMIN000006314, http://www.UMIN.ac.jp/ctr/index/htm/.

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Yoshinaga, K., Ohira, H., Tsujino, I. et al. Attenuated right ventricular energetics evaluated using 11C-acetate PET in patients with pulmonary hypertension. Eur J Nucl Med Mol Imaging 41, 1240–1250 (2014). https://doi.org/10.1007/s00259-014-2736-4

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  • DOI: https://doi.org/10.1007/s00259-014-2736-4

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