Cardio-pulmonary involvement in pulmonary arterial hypertension: A perfusion and innervation scintigraphic evaluation View Full Text


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Article Info

DATE

2019-03-22

AUTHORS

Alessia Gimelli, Nicola Riccardo Pugliese, Michelangelo Bertasi, Edoardo Airò, Carolina Bauleo, Bruno Formichi, Renato Prediletto, Paolo Marzullo, Simonetta Monti

ABSTRACT

BACKGROUND: Pulmonary arterial hypertension (PAH) is characterized by the right ventricle (RV) remodeling and pulmonary endothelial dysfunction. We studied cardiac perfusion and innervation in PAH with a cadmium-zinc-telluride (CZT) scanner and lung uptake impairment of 123I-metaiodobenzylguanidine (123I-MIBG). METHODS: In 13 patients with newly diagnosed PAH and 11 dilated cardiomyopathies (DCM, for comparative purposes), we assessed early and delayed 123I-MIBG uptake ratios of lung-to-mediastinum (L/M) and heart-to-mediastinum (H/M) on anterior planar images. A quantitative myocardial innervation with 123I-MIBG and perfusion with 99mTc-tetrofosmin using CZT-SPECT was performed. All patients underwent right heart catheterization. RESULTS: Early and delayed L/M ratios in PAH were lower than DCM (1.47 ± 0.14 vs 1.98 ± 0.11 and 1.40 ± 0.13 vs 1.83 ± 0.09; P < .001), while early and delayed H/M were impaired but not different (1.73 ± 0.20 vs 1.65 ± 0.18 and 1.73 ± 0.27 vs 1.58 ± 0.19). RV perfusion and early innervation were significantly higher in PAH compared to DCM (68.4 ± 13.4 vs 28.6 ± 4.1 and 58.8 ± 9.3 vs 27 ± 2.2; P < .001); delayed RV innervation was not evaluable. RV/LV perfusion and innervation ratios were significantly related (R = 0.74; P < .0001) and had a significant correlation with clinical, hemodynamic, and morpho-functional parameters, including L/M ratios. CONCLUSION: Cardio-pulmonary scintigraphy through a perfusion and innervation study is feasible and may identify pulmonary vascular and RV remodeling, as in PAH. More... »

PAGES

1-11

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12350-019-01689-w

DOI

http://dx.doi.org/10.1007/s12350-019-01689-w

DIMENSIONS

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PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30903609


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    "description": "BACKGROUND: Pulmonary arterial hypertension (PAH) is characterized by the right ventricle (RV) remodeling and pulmonary endothelial dysfunction. We studied cardiac perfusion and innervation in PAH with a cadmium-zinc-telluride (CZT) scanner and lung uptake impairment of 123I-metaiodobenzylguanidine (123I-MIBG).\nMETHODS: In 13 patients with newly diagnosed PAH and 11 dilated cardiomyopathies (DCM, for comparative purposes), we assessed early and delayed 123I-MIBG uptake ratios of lung-to-mediastinum (L/M) and heart-to-mediastinum (H/M) on anterior planar images. A quantitative myocardial innervation with 123I-MIBG and perfusion with 99mTc-tetrofosmin using CZT-SPECT was performed. All patients underwent right heart catheterization.\nRESULTS: Early and delayed L/M ratios in PAH were lower than DCM (1.47\u2009\u00b1\u20090.14 vs 1.98\u2009\u00b1\u20090.11 and 1.40\u2009\u00b1\u20090.13 vs 1.83\u2009\u00b1\u20090.09; P\u2009<\u2009.001), while early and delayed H/M were impaired but not different (1.73\u2009\u00b1\u20090.20 vs 1.65\u2009\u00b1\u20090.18 and 1.73\u2009\u00b1\u20090.27 vs 1.58\u2009\u00b1\u20090.19). RV perfusion and early innervation were significantly higher in PAH compared to DCM (68.4\u2009\u00b1\u200913.4 vs 28.6\u2009\u00b1\u20094.1 and 58.8\u2009\u00b1\u20099.3 vs 27\u2009\u00b1\u20092.2; P\u2009<\u2009.001); delayed RV innervation was not evaluable. RV/LV perfusion and innervation ratios were significantly related (R\u2009=\u20090.74; P\u2009<\u2009.0001) and had a significant correlation with clinical, hemodynamic, and morpho-functional parameters, including L/M ratios.\nCONCLUSION: Cardio-pulmonary scintigraphy through a perfusion and innervation study is feasible and may identify pulmonary vascular and RV remodeling, as in PAH.", 
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37 schema:description BACKGROUND: Pulmonary arterial hypertension (PAH) is characterized by the right ventricle (RV) remodeling and pulmonary endothelial dysfunction. We studied cardiac perfusion and innervation in PAH with a cadmium-zinc-telluride (CZT) scanner and lung uptake impairment of 123I-metaiodobenzylguanidine (123I-MIBG). METHODS: In 13 patients with newly diagnosed PAH and 11 dilated cardiomyopathies (DCM, for comparative purposes), we assessed early and delayed 123I-MIBG uptake ratios of lung-to-mediastinum (L/M) and heart-to-mediastinum (H/M) on anterior planar images. A quantitative myocardial innervation with 123I-MIBG and perfusion with 99mTc-tetrofosmin using CZT-SPECT was performed. All patients underwent right heart catheterization. RESULTS: Early and delayed L/M ratios in PAH were lower than DCM (1.47 ± 0.14 vs 1.98 ± 0.11 and 1.40 ± 0.13 vs 1.83 ± 0.09; P < .001), while early and delayed H/M were impaired but not different (1.73 ± 0.20 vs 1.65 ± 0.18 and 1.73 ± 0.27 vs 1.58 ± 0.19). RV perfusion and early innervation were significantly higher in PAH compared to DCM (68.4 ± 13.4 vs 28.6 ± 4.1 and 58.8 ± 9.3 vs 27 ± 2.2; P < .001); delayed RV innervation was not evaluable. RV/LV perfusion and innervation ratios were significantly related (R = 0.74; P < .0001) and had a significant correlation with clinical, hemodynamic, and morpho-functional parameters, including L/M ratios. CONCLUSION: Cardio-pulmonary scintigraphy through a perfusion and innervation study is feasible and may identify pulmonary vascular and RV remodeling, as in PAH.
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