Eur J Nucl Med Mol Imaging (2014) 41:1240–1250 DOI 10.1007/s00259-014-2736-4
ORIGINAL ARTICLE
Attenuated right ventricular energetics evaluated using 11 C-acetate PET in patients with pulmonary hypertension Keiichiro Yoshinaga & Hiroshi Ohira & Ichizo Tsujino & Noriko Oyama-Manabe & Lisa Mielniczuk & Rob S. B. Beanlands & Chietsugu Katoh & Katsuhiko Kasai & Osamu Manabe & Takahiro Sato & Satoshi Fujii & Yoichi M. Ito & Yuuki Tomiyama & Masaharu Nishimura & Nagara Tamaki
Received: 4 November 2013 / Accepted: 17 February 2014 / Published online: 11 March 2014 # Springer-Verlag Berlin Heidelberg 2014
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. Clinical trial registration: UMIN000006314, http://www.UMIN.ac.jp/ctr/ index/htm/. K. Yoshinaga (*) Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, Japan 060-8638 e-mail: [email protected] H. Ohira : I. Tsujino : T. Sato : M. Nishimura First Department of Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan N. Oyama-Manabe Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan L. Mielniczuk : R. S. B. Beanlands Division of Cardiology, Ottawa Heart Institute, Ottawa, Ontario, Canada C. Katoh : K. Kasai Faculty of Health Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan O. Manabe : Y. Tomiyama : N. Tamaki Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan S. Fujii Nagoya City University Graduate School of Pharmaceutical Sciences, Nagoya, Japan Y. M. Ito Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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 11Cacetate PET. 11C-acetate PET was used to simultaneously measure oxidative metabolism (kmono) 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 kmono (p =0.09). In contrast, PH patients showed higher RV kmono 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
ORIGINAL ARTICLE
Attenuated right ventricular energetics evaluated using 11 C-acetate PET in patients with pulmonary hypertension Keiichiro Yoshinaga & Hiroshi Ohira & Ichizo Tsujino & Noriko Oyama-Manabe & Lisa Mielniczuk & Rob S. B. Beanlands & Chietsugu Katoh & Katsuhiko Kasai & Osamu Manabe & Takahiro Sato & Satoshi Fujii & Yoichi M. Ito & Yuuki Tomiyama & Masaharu Nishimura & Nagara Tamaki
Received: 4 November 2013 / Accepted: 17 February 2014 / Published online: 11 March 2014 # Springer-Verlag Berlin Heidelberg 2014
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. Clinical trial registration: UMIN000006314, http://www.UMIN.ac.jp/ctr/ index/htm/. K. Yoshinaga (*) Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, Japan 060-8638 e-mail: [email protected] H. Ohira : I. Tsujino : T. Sato : M. Nishimura First Department of Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan N. Oyama-Manabe Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan L. Mielniczuk : R. S. B. Beanlands Division of Cardiology, Ottawa Heart Institute, Ottawa, Ontario, Canada C. Katoh : K. Kasai Faculty of Health Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan O. Manabe : Y. Tomiyama : N. Tamaki Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan S. Fujii Nagoya City University Graduate School of Pharmaceutical Sciences, Nagoya, Japan Y. M. Ito Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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 11Cacetate PET. 11C-acetate PET was used to simultaneously measure oxidative metabolism (kmono) 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 kmono (p =0.09). In contrast, PH patients showed higher RV kmono 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
