Ferreira Maria João, Marques-Alves Patrícia, Silva Rodolfo, Gomes Andreia, Abrunhosa Antero, Castelo-Branco Miguel, Jaber Wael, Gonçalves Lino
Universidade de Coimbra, Coimbra, Portugal.
Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal.
EJNMMI Res. 2025 Feb 28;15(1):18. doi: 10.1186/s13550-025-01212-y.
Hypertrophic Cardiomyopathy (HCM), a genetic disorder with diverse phenotypes, is associated with risks of heart failure and sudden cardiac death. While the condition involves multiple pathological pathways, including myocardial inflammation, increased workload, myocyte disarray, apoptosis, and fibrosis, the role of molecular imaging via PET-CT remains unexplored in this context. This study aimed to investigate the relationship between myocardial metabolism and perfusion using PET-CT in patients with non-obstructive HCM (NOHCM).
Myocardial perfusion and metabolism were assessed using PET-CT with [N]NH3 and 2-[F]FDG uptake, respectively, in 30 NOHCM patients. Baseline measurements included maximal myocardial wall thickness (MMWT), left atrial volume (LAV), NT-proBNP levels, and the sudden cardiac death (SCD) risk score. Increased 2-[F]FDG uptake (Target to Background Ratio - TBR ≥ 1.1) was detected in 53% of patients, with an average TBR of 1.4 ± 0.5. The inflammatory pattern involved 11.8 ± 17.2% of the left ventricle (LV) and correlated with MMWT (rho = 0.49, p = 0.009), LAV (rho = 0.39, p = 0.04), and NT-proBNP levels (rho = 0.63, p = 0.003). The maximum TBR within the LV correlated with MMWT (rho = 0.53, p = 0.004), NT-proBNP (rho = 0.70,p = 0.0008), and the SCD risk score (rho = 0.38,p = 0.04). Additionally, the fibrotic (scar) pattern, involving 10.3 ± 10.2% of the LV, correlated with the SCD score (rho = 0.38,p = 0.04).
In patients with NOHCM, PET-CT imaging provides valuable insights into myocardial metabolism and fibrosis, which are closely associated with myocardial hypertrophy, left ventricular dysfunction, and the risk of sudden cardiac death.
肥厚型心肌病（HCM）是一种具有多种表型的遗传性疾病，与心力衰竭和心源性猝死风险相关。虽然该疾病涉及多种病理途径，包括心肌炎症、工作量增加、心肌细胞紊乱、细胞凋亡和纤维化，但在此背景下，通过PET-CT进行分子成像的作用仍未得到探索。本研究旨在使用PET-CT研究非梗阻性HCM（NOHCM）患者心肌代谢与灌注之间的关系。
分别使用[ N ] NH3和2-[ F ] FDG摄取的PET-CT对30例NOHCM患者的心肌灌注和代谢进行评估。基线测量包括最大心肌壁厚度（MMWT）、左心房容积（LAV）、NT-proBNP水平和心源性猝死（SCD）风险评分。53%的患者检测到2-[ F ] FDG摄取增加（靶本比 - TBR≥1.1），平均TBR为1.4±0.5。炎症模式累及左心室（LV）的11.8±17.2%，并与MMWT（rho = 0.49，p = 0.009）、LAV（rho = 0.39，p = 0.04）和NT-proBNP水平（rho = 0.63，p = 0.003）相关。LV内的最大TBR与MMWT（rho = 0.53，p = 0.004）、NT-proBNP（rho = 0.70，p = 0.0008）和SCD风险评分（rho = 0.38，p = 0.04）相关。此外，纤维化（瘢痕）模式累及LV的10.3±10.2%，与SCD评分相关（rho = 0.38，p = 0.
