Association of PET-measured myocardial flow reserve with echocardiography-estimated pulmonary artery systolic pressure in patients with hypertrophic cardiomyopathy

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Abstract

Background Pulmonary hypertension (PH) is a known complication of HCM and is a strong predictor of mortality. We aim to investigate the relationship between microvascular dysfunction measured by quantitative PET and PH in HCM patients. Methods Eighty-nine symptomatic HCM patients were included in the study. Each patient underwent two 20-min 13 N-NH 3 dynamic PET scans for rest and stress conditions, respectively. A 2-tis-sue irreversible compartmental model was used to fit the segments time activity curves for estimating segmental and global myocardial blood flow (MBF) and myocardial flow reserve (MFR). Echocardiographic derived PASP was utilized to estimate PH. Results Patients were categorized into two groups across PASP: PH (PASP > 36 mmHg) and no-PH (PASP 36 mmHg). patients with PH had larger left atrium, ratio of higher inflow early diastole (E) and atrial contraction (A) waves, E/A, and ratio of inflow and peak early diastolic waves, E/e’, significantly reduced global stress MBF (1.85 ± 0.52 vs. 2.13 ± 0.56 ml/min/g; p = 0.024) and MFR (2.21 ± 0.57 vs. 2.62 ± 0.75; p = 0.005), while the MBFs at rest between the two groups were similar. There were significant negative correlations between global stress MBF/MFR and PASP (stress MBF: r = -0.23, p = 0.03; MFR: r = -0.32, p = 0.002); for regional MBF and MFR measurements, the highest linear correlation coefficients were observed in the septal wall (stress MBF: r = -0.27, p = 0.01; MFR: r = -0.31, p = 0.003). Global MFR was identified to be independent predictor for PH in multivariate regression analysis. Conclusion Echocardiography-derived PASP is negatively correlated with global MFR measured by 13 N-NH 3 dynamic PET. Global MFR is suggested to be an index of PH in HCM patients.

Original languageEnglish (US)
Article numbere0212573
JournalPloS one
Volume14
Issue number3
DOIs
StatePublished - Mar 1 2019

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Echocardiography
pulmonary artery
Hypertrophic Cardiomyopathy
cardiomyopathy
echocardiography
Pulmonary Hypertension
Pulmonary Artery
hypertension
Blood
Blood Pressure
lungs
blood flow
Regression analysis
Diastole
positron-emission tomography
Regional Blood Flow
Heart Atria
4-S-(propionic acid)sulfidocyclophosphamide
Positron-Emission Tomography
Multivariate Analysis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{088b7f68a6744dbb873d1b13599df79b,
title = "Association of PET-measured myocardial flow reserve with echocardiography-estimated pulmonary artery systolic pressure in patients with hypertrophic cardiomyopathy",
abstract = "Background Pulmonary hypertension (PH) is a known complication of HCM and is a strong predictor of mortality. We aim to investigate the relationship between microvascular dysfunction measured by quantitative PET and PH in HCM patients. Methods Eighty-nine symptomatic HCM patients were included in the study. Each patient underwent two 20-min 13 N-NH 3 dynamic PET scans for rest and stress conditions, respectively. A 2-tis-sue irreversible compartmental model was used to fit the segments time activity curves for estimating segmental and global myocardial blood flow (MBF) and myocardial flow reserve (MFR). Echocardiographic derived PASP was utilized to estimate PH. Results Patients were categorized into two groups across PASP: PH (PASP > 36 mmHg) and no-PH (PASP 36 mmHg). patients with PH had larger left atrium, ratio of higher inflow early diastole (E) and atrial contraction (A) waves, E/A, and ratio of inflow and peak early diastolic waves, E/e’, significantly reduced global stress MBF (1.85 ± 0.52 vs. 2.13 ± 0.56 ml/min/g; p = 0.024) and MFR (2.21 ± 0.57 vs. 2.62 ± 0.75; p = 0.005), while the MBFs at rest between the two groups were similar. There were significant negative correlations between global stress MBF/MFR and PASP (stress MBF: r = -0.23, p = 0.03; MFR: r = -0.32, p = 0.002); for regional MBF and MFR measurements, the highest linear correlation coefficients were observed in the septal wall (stress MBF: r = -0.27, p = 0.01; MFR: r = -0.31, p = 0.003). Global MFR was identified to be independent predictor for PH in multivariate regression analysis. Conclusion Echocardiography-derived PASP is negatively correlated with global MFR measured by 13 N-NH 3 dynamic PET. Global MFR is suggested to be an index of PH in HCM patients.",
author = "Min Zhao and Min Liu and Leal, {Jeffrey Pettit} and Benjamin Tsui and Wong, {Dean Foster} and Pomper, {Martin Gilbert} and Yun Zhou",
year = "2019",
month = "3",
day = "1",
doi = "10.1371/journal.pone.0212573",
language = "English (US)",
volume = "14",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "3",

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TY - JOUR

T1 - Association of PET-measured myocardial flow reserve with echocardiography-estimated pulmonary artery systolic pressure in patients with hypertrophic cardiomyopathy

AU - Zhao, Min

AU - Liu, Min

AU - Leal, Jeffrey Pettit

AU - Tsui, Benjamin

AU - Wong, Dean Foster

AU - Pomper, Martin Gilbert

AU - Zhou, Yun

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background Pulmonary hypertension (PH) is a known complication of HCM and is a strong predictor of mortality. We aim to investigate the relationship between microvascular dysfunction measured by quantitative PET and PH in HCM patients. Methods Eighty-nine symptomatic HCM patients were included in the study. Each patient underwent two 20-min 13 N-NH 3 dynamic PET scans for rest and stress conditions, respectively. A 2-tis-sue irreversible compartmental model was used to fit the segments time activity curves for estimating segmental and global myocardial blood flow (MBF) and myocardial flow reserve (MFR). Echocardiographic derived PASP was utilized to estimate PH. Results Patients were categorized into two groups across PASP: PH (PASP > 36 mmHg) and no-PH (PASP 36 mmHg). patients with PH had larger left atrium, ratio of higher inflow early diastole (E) and atrial contraction (A) waves, E/A, and ratio of inflow and peak early diastolic waves, E/e’, significantly reduced global stress MBF (1.85 ± 0.52 vs. 2.13 ± 0.56 ml/min/g; p = 0.024) and MFR (2.21 ± 0.57 vs. 2.62 ± 0.75; p = 0.005), while the MBFs at rest between the two groups were similar. There were significant negative correlations between global stress MBF/MFR and PASP (stress MBF: r = -0.23, p = 0.03; MFR: r = -0.32, p = 0.002); for regional MBF and MFR measurements, the highest linear correlation coefficients were observed in the septal wall (stress MBF: r = -0.27, p = 0.01; MFR: r = -0.31, p = 0.003). Global MFR was identified to be independent predictor for PH in multivariate regression analysis. Conclusion Echocardiography-derived PASP is negatively correlated with global MFR measured by 13 N-NH 3 dynamic PET. Global MFR is suggested to be an index of PH in HCM patients.

AB - Background Pulmonary hypertension (PH) is a known complication of HCM and is a strong predictor of mortality. We aim to investigate the relationship between microvascular dysfunction measured by quantitative PET and PH in HCM patients. Methods Eighty-nine symptomatic HCM patients were included in the study. Each patient underwent two 20-min 13 N-NH 3 dynamic PET scans for rest and stress conditions, respectively. A 2-tis-sue irreversible compartmental model was used to fit the segments time activity curves for estimating segmental and global myocardial blood flow (MBF) and myocardial flow reserve (MFR). Echocardiographic derived PASP was utilized to estimate PH. Results Patients were categorized into two groups across PASP: PH (PASP > 36 mmHg) and no-PH (PASP 36 mmHg). patients with PH had larger left atrium, ratio of higher inflow early diastole (E) and atrial contraction (A) waves, E/A, and ratio of inflow and peak early diastolic waves, E/e’, significantly reduced global stress MBF (1.85 ± 0.52 vs. 2.13 ± 0.56 ml/min/g; p = 0.024) and MFR (2.21 ± 0.57 vs. 2.62 ± 0.75; p = 0.005), while the MBFs at rest between the two groups were similar. There were significant negative correlations between global stress MBF/MFR and PASP (stress MBF: r = -0.23, p = 0.03; MFR: r = -0.32, p = 0.002); for regional MBF and MFR measurements, the highest linear correlation coefficients were observed in the septal wall (stress MBF: r = -0.27, p = 0.01; MFR: r = -0.31, p = 0.003). Global MFR was identified to be independent predictor for PH in multivariate regression analysis. Conclusion Echocardiography-derived PASP is negatively correlated with global MFR measured by 13 N-NH 3 dynamic PET. Global MFR is suggested to be an index of PH in HCM patients.

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