Pulmonary endarterectomy normalizes interventricular dyssynchrony and right ventricular systolic wall stress

  • Design I
  • Flange O
  • Return R
 et al. 
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Abstract

OBJECTIVES: We examined whether right ventricular (RV) [ 18F]fluorodeoxyglucose (FDG) accumulation is increased in patients with pulmonary hypertension using gated positron emission tomography (PET) and whether RV FDG accumulation changes after therapy with epoprostenol. BACKGROUND: Myocardial glucose utilization is increased in animal models with ventricular pressure overload. METHODS: We performed gated FDG-PET in 24 patients with pulmonary hypertension. The RV standardized uptake value (SUV) of FDG was corrected for the partial volume effect based on the wall thickness measured by electron-beam computed tomography or magnetic resonance imaging. RESULTS: The corrected RV SUV of FDG was significantly correlated with the pulmonary vascular resistance, mean pulmonary artery pressure, right atrial pressure, RV wall stress, and plasma brain natriuretic peptide levels, but not with the RV wall thickness and mass. After pulmonary vasodilator therapy with epoprostenol for three months, the corrected RV SUV of FDG significantly decreased in the responders, but not in the non-responders, and the percentage change of the corrected RV SUV of FDG was significantly correlated with the percentage change of the pulmonary vascular resistance (r = 0.78; p < 0.01) and RV systolic wall stress (r = 0.76; p < 0.05). CONCLUSIONS: The RV FDG accumulation corrected for the partial volume effect was significantly increased in accordance with the severity of the RV pressure overload (i.e., the RV peak-systolic wall stress) in patients with pulmonary hypertension. Furthermore, the corrected RV FDG accumulation was decreased after the treatment with epoprostenol in accordance with the degree of reduction in the pulmonary vascular resistance and RV peak-systolic wall stress. © 2005 by the American College of Cardiology Foundation.

Author-supplied keywords

  • ATRIAL
  • Age
  • CONGENITAL HEART-DISEASE
  • CONTRACTILE STATE
  • CORRECTED MEAN VELOCITY
  • Cardiac
  • ECHOCARDIOGRAPHIC ASSESSMENT
  • ECHOCARDIOGRAPHIC-ASSESSMENT
  • EJECTION
  • Echocardiograms
  • GRADIENT
  • HEART
  • HEART-RATE
  • INCREASE
  • LEFT-VENTRICLE
  • LOADING CONDITIONS
  • Left
  • Magnetic resonance imaging
  • Methods
  • Natriuretic peptide
  • Normal
  • PRESSURE-VOLUME RELATION
  • Pressure
  • Pulmonary
  • Pulmonary hypertension
  • Pulmonic
  • Right
  • Right ventricle
  • Right ventricular function
  • SURFACE- AREA
  • SYSTOLIC STRESS
  • Stenosis
  • Stress
  • TIME
  • Two-dimensional echocardiography
  • VELOCITIES
  • VELOCITY
  • VOLUME
  • Ventricular
  • WALL
  • WALL-STRESS
  • atrial septal defect
  • basic science curriculum at
  • cardiac remodeling
  • children
  • chronic thrombo-embolic pulmonary hypertension
  • college of osteopathic
  • control
  • correlation
  • echocardiographic
  • effects
  • ejection fraction
  • heart rate
  • hypertrophy
  • idiopathic
  • interventricular
  • law of laplace
  • left ventricle
  • mechanical asynchrony
  • medicine have included a
  • myocardial strain
  • of
  • pressure gradient
  • pressure overload
  • primary
  • pulmonary endarterectomy
  • pulmonary hyperten-
  • pulmonary stenosis
  • pulmonic stenosis
  • recent changes in the
  • reduction in the number
  • right ventricular heart failure
  • septal
  • septal defect
  • sion
  • systolic
  • systolic function
  • the
  • university of new england
  • wall stress
  • wall tension

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Authors

  • Inside Design

  • Overall Flange

  • Return Return

  • Bend Thick-

  • Jamstud Section

  • R F Janz

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