PDF(Pubmed)
Abstract：
Atrial fibrillation (AF) is a progressive disease from paroxysmal to persistent, and persistent AF (PerAF) had worse prognosis. AF has potential link with inflammation, but it is not clear whether PerAF or paroxysmal AF (ParAF) is more closely related to inflammation. On the basis of inhibiting myocardial physiological uptake, 18F-fluorodeoxyglucosepositron emission tomography/computed tomography (18F-FDG PET/CT) is an established imaging modality to detect cardiac inflammation. We aimed to decipher the association between AF and atrial inflammatory activity by 18F-FDG PET/CT.
Thirty-five PerAF patients were compared to age and sex matched ParAF group with baseline 18F-FDG PET/CT scans prior to radiofrequency catheter ablation (RFCA) in the prospective case-control study. High-fat and low-carbohydrate diet and prolonged fast (HFLC+Fast) was applied to all AF patients before PET/CT. Then 22 AF patients with positive right atrial (RA) wall FDG uptake (HFLC+Fast) were randomly selected and underwent HFLC+Fast+heparin the next day. The CHA2DS2-VASc score was calculated to evaluate the risk of stroke. Clinical data, ECG, echocardiography, and atrial 18F-FDG uptake were compared.
PerAF patients had significantly higher probability of RA wall positive FDG uptake and higher SUVmax than ParAF group [91.4% VS. 28.6%, P < 0.001; SUVmax: 4.10(3.20-4.90) VS. 2.60(2.40-3.10), P < 0.001]. Multivariate logistic regression analyses demonstrated that RA wall SUVmax was the independent influencing factor of PerAF (OR = 1.80, 95%CI 1.02-3.18, P = 0.04). In 22 AF patients with RA wall positive FDG uptake (HFLC+Fast), the \"HFLC+Fast+Heparin\" method did not significantly change RA wall FDG uptake evaluated by either quantitative analysis or visual analysis. High CHA2DS2-VASc score group had higher RA wall 18F-FDG uptake [3.35 (2.70, 4.50) vs, 2.8 (2.4, 3.1) P = 0.01].
RA wall FDG positive uptake was present mainly in PerAF. A higher RA wall 18F-FDG uptake was an independent influencing factor of PerAF. RA wall FDG uptake based on 18F-FDG PET/CT may indicate pathological inflammation.
http://www.chictr.org.cn , ChiCTR2000038288.
Thirty-five PerAF patients were compared to age and sex matched ParAF group with baseline 18F-FDG PET/CT scans prior to radiofrequency catheter ablation (RFCA) in the prospective case-control study. High-fat and low-carbohydrate diet and prolonged fast (HFLC+Fast) was applied to all AF patients before PET/CT. Then 22 AF patients with positive right atrial (RA) wall FDG uptake (HFLC+Fast) were randomly selected and underwent HFLC+Fast+heparin the next day. The CHA2DS2-VASc score was calculated to evaluate the risk of stroke. Clinical data, ECG, echocardiography, and atrial 18F-FDG uptake were compared.
PerAF patients had significantly higher probability of RA wall positive FDG uptake and higher SUVmax than ParAF group [91.4% VS. 28.6%, P < 0.001; SUVmax: 4.10(3.20-4.90) VS. 2.60(2.40-3.10), P < 0.001]. Multivariate logistic regression analyses demonstrated that RA wall SUVmax was the independent influencing factor of PerAF (OR = 1.80, 95%CI 1.02-3.18, P = 0.04). In 22 AF patients with RA wall positive FDG uptake (HFLC+Fast), the \"HFLC+Fast+Heparin\" method did not significantly change RA wall FDG uptake evaluated by either quantitative analysis or visual analysis. High CHA2DS2-VASc score group had higher RA wall 18F-FDG uptake [3.35 (2.70, 4.50) vs, 2.8 (2.4, 3.1) P = 0.01].
RA wall FDG positive uptake was present mainly in PerAF. A higher RA wall 18F-FDG uptake was an independent influencing factor of PerAF. RA wall FDG uptake based on 18F-FDG PET/CT may indicate pathological inflammation.
http://www.chictr.org.cn , ChiCTR2000038288.
摘要：
目的：心房颤动（AF）是一种从阵发性到持续性的进行性疾病，持续性房颤（PerAF）预后较差。房颤与炎症有潜在的联系,但尚不清楚PerAF或阵发性AF（ParAF）是否与炎症更密切相关。在抑制心肌生理摄取的基础上,18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDGPET/CT）是一种已建立的成像方式来检测心脏炎症。我们旨在通过18F-FDGPET/CT破译房颤与心房炎症活动之间的关联。
方法：在前瞻性病例对照研究中，在射频导管消融（RFCA）之前，将35例PerAF患者与年龄和性别匹配的ParAF组进行基线18F-FDGPET/CT扫描。在PET/CT之前，对所有AF患者应用高脂低碳水化合物饮食和长期禁食（HFLCFast）。然后随机选择22例右心房（RA）壁FDG摄取（HFLCFast）阳性的AF患者，第二天接受HFLCFast肝素治疗。计算CHA2DS2-VASc评分以评估卒中风险。临床数据,心电图,超声心动图,和心房18F-FDG摄取进行比较。
结果：与ParAF组相比，PerAF患者RA壁FDG摄取阳性和SUVmax明显更高[91.4%VS。28.6%,P<0.001;SUVmax:4.10(3.20-4.90)VS。2.60(2.40-3.10),P<0.001]。多因素logistic回归分析显示RA壁SUVmax是PerAF的独立影响因素(OR=1.80,95CI1.02～3.18,P=0.04)。在22例RA壁FDG摄取阳性的AF患者中（HFLC+Fast），“HFLC+Fast+肝素”方法通过定量分析或目测分析评估的RA壁FDG摄取无显著变化.高CHA2DS2-VASc评分组RA壁18F-FDG摄取较高[3.35（2.70，4.50）vs，2.8(2.4,3.1)P=0.01]。
结论：RA壁FDG阳性摄取主要存在于PerAF中。较高的RA壁18F-FDG摄取是PerAF的独立影响因素。基于18F-FDGPET/CT的RA壁FDG摄取可能提示病理性炎症。
背景：http://www.chictr.org.cn,ChiCTR2000038288。
方法：在前瞻性病例对照研究中，在射频导管消融（RFCA）之前，将35例PerAF患者与年龄和性别匹配的ParAF组进行基线18F-FDGPET/CT扫描。在PET/CT之前，对所有AF患者应用高脂低碳水化合物饮食和长期禁食（HFLCFast）。然后随机选择22例右心房（RA）壁FDG摄取（HFLCFast）阳性的AF患者，第二天接受HFLCFast肝素治疗。计算CHA2DS2-VASc评分以评估卒中风险。临床数据,心电图,超声心动图,和心房18F-FDG摄取进行比较。
结果：与ParAF组相比，PerAF患者RA壁FDG摄取阳性和SUVmax明显更高[91.4%VS。28.6%,P<0.001;SUVmax:4.10(3.20-4.90)VS。2.60(2.40-3.10),P<0.001]。多因素logistic回归分析显示RA壁SUVmax是PerAF的独立影响因素(OR=1.80,95CI1.02～3.18,P=0.04)。在22例RA壁FDG摄取阳性的AF患者中（HFLC+Fast），“HFLC+Fast+肝素”方法通过定量分析或目测分析评估的RA壁FDG摄取无显著变化.高CHA2DS2-VASc评分组RA壁18F-FDG摄取较高[3.35（2.70，4.50）vs，2.8(2.4,3.1)P=0.01]。
结论：RA壁FDG阳性摄取主要存在于PerAF中。较高的RA壁18F-FDG摄取是PerAF的独立影响因素。基于18F-FDGPET/CT的RA壁FDG摄取可能提示病理性炎症。
背景：http://www.chictr.org.cn,ChiCTR2000038288。
