Prognostic value of 18F-FDG PET/CT imaging of inflammation in evaluating left ventricle function in patients with acute myocardial infarction
10.3760/cma.j.cn321828-20211019-00362
- VernacularTitle:18F-FDG PET/CT炎症显像评价急性心肌梗死患者左心功能的预后价值
- Author:
Qingxiang WEN
1
;
Xiaoying XI
;
Dandan YAO
;
Minfu YANG
Author Information
1. 首都医科大学附属北京中医医院核医学科，北京 100010
- Keywords:
Myocardial infarction;
Ventricular function, left;
Inflammation;
Positron-emission tomography;
Tomography, X-ray computed;
Fluorodeoxyglucose F18
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2022;42(8):452-456
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of 18F-FDG PET/CT myocardial inflammation imaging in evaluating the functional prognosis of left ventricle (LV) in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). Methods:Thirty-one patients (26 males, 5 females, age: (55.4±10.1) years) with acute ST-elevation myocardial infarction (STEMI) referred for PCI in Beijing Chaoyang Hospital between January 2016 and December 2016 were prospectively included. All patients underwent 18F-FDG PET/CT following 99Tc m-methoxyisobutylisonitrile (MIBI) rest myocardial perfusion imaging (MPI) on the fifth day after PCI. A comprehensive strategy recommended by guideline was followed to suppress myocardial uptake. 18F-FDG uptake in infarcted and remote myocardium were quantitatively analyzed by measuring SUV max, and that in superior vena cava was quantitatively analyzed by measuring SUV mean. Target-to-background ratios (TBRs) in infarcted and remote area were calculated. In addition, the following parameters were obtained: 18F-FDG uptake volume of LV (Vol-FDG), percentage of 18F-FDG uptake size of LV (F/LV%) , percentage of myocardial perfusion defect size of LV (def/LV%). According to the left ventricular ejection fraction (EF) at baseline and 6 months after AMI, the changing rate of EF (ΔEF) was calculated, and data of patients in improvement group (ΔEF≥10%) and no improvement group (ΔEF<10%) were compared. Independent-sample t test or Mann-Whitney U test, and Pearson correlation analysis or Spearman rank correlation analysis were used for data analysis. Results:TBR was significantly higher in infarcted myocardium than that in remote area (2.8±1.0 vs 1.1±0.3; t=11.03, P<0.001). F/LV% was greater than def/LV% (33.7%(25.8%, 43.3%) vs 8.8%(2.3%, 20.7%); z=-4.72, P<0.001). TBR in both infarcted and remote areas showed positive correlations with peripheral blood monocyte counts ( r=0.44, P=0.014; r=0.37, P=0.042). Vol-FDG had positive correlations with the myocardial injury markers (creatine kinase (CK), CK isoenzyme (CK-MB), cardiac troponin I (cTnI); r values: 0.46, 0.41, 0.68, all P<0.05). Of the 31 patients, 26(83.9%) completed the 6-month follow-up. Vol-FDG in no improvement group ( n=11) was significantly greater than that in improvement group ( n=15; (104.5±47.2) vs (70.1±26.3) cm 3;t=2.38, P=0.026). There was a negative correlation between Vol-FDG and ΔEF ( rs=-0.41, P=0.038). Conclusion:18F-FDG PET/CT imaging can evaluate the intensity and size of myocardial inflammation, and estimate the functional prognosis of LV in patients with AMI undergoing PCI.
