Positron emission tomography (15O-water, 11C-acetate, 11C-HED) risk markers and nonsustained ventricular tachycardia in hypertrophic cardiomyopathy.
Int J Cardiol Heart Vasc
; 26: 100452, 2020 Feb.
Article
em En
| MEDLINE
| ID: mdl-32140548
ABSTRACT
BACKGROUND:
The objectives of the study were to describe positron emission tomography (PET) parameters, using the tracers 15O-water at rest/stress, 11C-acetate, and 11C-HED, with regard to nonsustained ventricular tachycardia (NSVT) in hypertrophic cardiomyopathy (HCM). PET offers quantitative assessment of pathophysiology throughout the left ventricular segments, including the endocardium/epicardium. The potential use PET in risk stratification remains to be elucidated. NSVT provides a marker for sudden cardiac death.METHODS:
Patients with a validated diagnosis of HCM who had an implantable cardioverter-defibrillator were interrogated at 12â¯months and independently of PET-examinations.RESULTS:
In total, 25 patients (mean age 56.8⯱â¯12.9â¯years, 76% males) were included and 10 reported NSVT. Mean myocardial blood flow (MBF) at rest was 0.91â¯ml/g/min and decreased at stress, 1.59â¯ml/g/min. The mean gradient (endocardium/epicardium quotient) at rest was 1.14⯱â¯0.09, while inverse at stress (mean 0.92⯱â¯0.16). Notably, MBF gradient at stress was significantly lower in patients with NSVT (pâ¯=â¯0.022) and borderline at rest (pâ¯=â¯0.059) while global MBF at rest and stress were not. Mean myocardial oxygen consumption (MVO2) was 0.088â¯ml/g/min (higher in NSVT, pâ¯=â¯0.023) and myocardial external efficiency 18.5%. Using 11C-HED, the mean retention index was 0.11â¯min-1 and a higher volume of distribution (pâ¯=â¯0.089) or transmural gradient of clearance rate (pâ¯=â¯0.061) or lower clearance rate (pâ¯=â¯0.052) showed a tendency of association of NSVT.CONCLUSIONS:
The endocardium/epicardium MBF gradient at stress is significantly lower in HCM patients with NSVT. This provides a novel approach to further refine risk stratification of sudden cardiac death.
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Int J Cardiol Heart Vasc
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Suécia