کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2921808 1175804 2015 11 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Incidence of abnormal positron emission tomography in patients with unexplained cardiomyopathy and ventricular arrhythmias: The potential role of occult inflammation in arrhythmogenesis
ترجمه فارسی عنوان
فراوانی توموگرافی انتشار پوزیترون غیرطبیعی در بیماران مبتلا به کراتومیوپاتی ناشناخته و آریتمی های بطنی: نقش بالقوه التهاب مخفی در آریتموژنز
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

BackgroundThe incidence of myocardial inflammation in patients with unexplained cardiomyopathy referred for ventricular arrhythmias (VAs) is unknown.ObjectiveThe purpose of this study was to report fasting positron emission tomographic (PET) scan findings in consecutive patients referred with unexplained cardiomyopathy and VA.MethodsFluorine-18 fluoro-2-deoxyglucose (18-FDG) PET/computed tomographic (CT) scans with a >16-hour fasting protocol were prospectively ordered for patients referred for VA and unexplained cardiomyopathy (ejection fraction <55%). Patients with focal myocardial FDG uptake were labeled as arrhythmogenic inflammatory cardiomyopathy (AIC) and classified into 4 groups based on the presence of lymph node uptake (AIC+) and perfusion abnormalities (early vs late stage).ResultsOver a 3-year period, 103 PET scans were performed, with 49% (AIC+ 17, AIC 33) exhibiting focal FDG uptake. Mean patient age was 52 ± 12 years (ejection fraction 36% ± 16%). Patients with AIC were more likely to have a history of pacemaker (32% vs 6%, P = .002) compared to those with normal PET. When biopsy was performed, histologic diagnosis revealed nongranulomatous inflammation in 6 patients and sarcoidosis in 18 patients. Ninety percent of patients with AIC/AIC+ were prescribed immunosuppressive therapy, and 58% underwent ablation. Correlation between low voltage regions on electroanatomic mapping and FDG uptake was observed in 74%. Magnetic resonance imaging findings matched abnormal PET regions in only 40%.ConclusionNearly 50% of patients referred with unexplained cardiomyopathy and VA demonstrate ongoing focal myocardial inflammation on FDG PET. These data suggest that a significant proportion of patients labeled “idiopathic” may have occult AIC, which may benefit from early detection and immunosuppressive medical therapy.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Heart Rhythm - Volume 12, Issue 12, December 2015, Pages 2488–2498
نویسندگان
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