扩张型心肌病右心室心肌葡萄糖代谢与右心功能的相关性研究

Relationship Between Right Ventricular Glucose Metabolism and Right Heart Function in Patients With Dilated Cardiomyopathy

目的 :利用18氟—脱氧葡萄糖(18F-FDG)发射型正电子断层(PET)心肌代谢显像,评价扩张型心肌病(DCM)右心室心肌葡萄糖代谢与右心功能之间的关系。方法:34例连续入选的DCM患者均行18F-FDG PET心肌代谢显像,参照Herrero法,获得校正的右心室游离壁心肌(c RV)标准化摄取值(SUV)、左心室游离壁心肌(c LV)SUV和两者的比值(c R/L);34例患者均在7 d之内完成心脏磁共振成像(c MRI),通过Simpson’s原则自动计算获得左心室射血分数(LVEF)和右心室射血分数(RVEF)。采用超声心动图测定肺动脉收缩压。结果:校正的c RVSUV和c R/L均与c MRI测得的RVEF有显著的负相关(分别为r=-0.513,P<0.01和r=-0.463,P<0.01),c RVSUV和c R/L同时也与LVEF呈负相关(分别为r=-0.387,P<0.01和r=-0.362,P<0.01)。结论 :右心室心肌葡萄糖代谢增强与右心室功能障碍密切相关,利用18F-FDG PET心肌代谢显像检测右心室18F-FDG摄取,有可能成为评价DCM右心功能及预后的有效指标。

Objective： To investigate the relationship between right ventricular （RV） glucose metabolism by 18^F-fludeoxyglucose positron emission tomography （18^F-FDG PET） and right heart function in patients with dilated cardiomyopathy （DCM）. Methods： The tSF-FDG PET imaging was performed in 34 consecutive DCM patients, with the reference of Herrero method, the corrected RV standard uptake value （cRVSUV）, corrected left ventricular standard uptake value （cLVSUV） and the ratio of RV to LV SUV （oR/L） were obtained. And all 34 patients received cardiac magnetic resonance imaging （cMRI） examination within 7 days, the left ventricular ejection fraction （LVEF） and RVEF were automatically calculated with Simpson＇s principle. The pulmonary arterial systolic pressure was measured by echocardiography. Results： The corrected cRVSUV and cR/L by ~SF-FDG PET were negatively related to RVEF by cMRI, （r=-0.513, P〈0.01） and （r=-0.463, P〈0.01） respectively, and meanwhile, the corrected cRVSUV and cR/L were also negatively related to LVEF, （r=-0.387, P〈0.01 and r=-0.362, P〈0.01） respectively. Conclusion： Increased RV glucose metabolism closely related to RV dysfunction, the 18^F-FDG uptake value by PET might be used as an index for assessing the right heart function and prognosis in DCM patients.