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Marchandise S, Roelants V, Raoult T, Garnir Q, Scavée C, Varnavas V, Wauters A, Gruson D, Nellessen E, Hesse M, Beauloye C, Gerber BL. Left Atrial Glucose Metabolism Evaluation by 18F-FDG-PET in Persistent Atrial Fibrillation and in Sinus Rhythm. JACC Basic Transl Sci 2024; 9:459-471. [PMID: 38680960 PMCID: PMC11055205 DOI: 10.1016/j.jacbts.2023.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 05/01/2024]
Abstract
The role of atrial metabolism alterations for initiation and atrial fibrillation (AF) persistence remains poorly understood. Therefore, we evaluated left atrial glucose metabolism by nicotinic acid derivative stimulated 18-fluorodeoxyglucose positron emission tomography in 36 patients with persistent AF undergoing catheter ablation before and 3 months after return to sinus rhythm and compared values against healthy controls. Under identical hemodynamics and metabolic conditions, and although left ventricular FDG uptake remained unchanged, patients in persistent AF presented significantly higher total left atrial and left atrial appendage uptake, which decreased significantly after return to sinus rhythm, despite improvement of passive and active atrial contractile function. These findings support a role of altered glucose metabolism and metabolic wasting underlying the pathophysiology of persistent AF.
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Affiliation(s)
- Sébastien Marchandise
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
| | - Véronique Roelants
- Division of Nuclear Medicine, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pole Molecular Imaging, Radiotherapy & Oncology (MIRO), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Tristan Raoult
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
| | - Quentin Garnir
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
| | - Christophe Scavée
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
| | - Varnavas Varnavas
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
| | - Aurélien Wauters
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
| | - Damien Gruson
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
| | - Eric Nellessen
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
| | - Michel Hesse
- Division of Nuclear Medicine, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pole Molecular Imaging, Radiotherapy & Oncology (MIRO), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Christophe Beauloye
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
| | - Bernhard L. Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium
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Li L, Gao J, Chen BX, Liu X, Shi L, Wang Y, Wang L, Wang Y, Su P, Yang MF, Xie B. Fibroblast activation protein imaging in atrial fibrillation: a proof-of-concept study. J Nucl Cardiol 2023; 30:2712-2720. [PMID: 37626209 DOI: 10.1007/s12350-023-03352-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND To evaluate the feasibility of using radiolabeled fibroblast activation protein inhibitor (FAPI) PET/CT imaging to assess activated fibroblasts in the atria of individuals with AF and to identify factors contributing to enhanced atrial activity. METHODS We constructed left atrial appendage (LAA) pacing beagle dog AF models (n = 5) and conducted 18F-FAPI PET/CT imaging at baseline and eight weeks after pacing. Right atrial (RA) specimens were collected from these models. Additionally, 28 AF patients and ten age- and sex-matched healthy volunteers underwent 18F-FAPI PET/CT imaging. RESULTS RA of AF beagles showed increased 18F-FAPI uptake. Among AF patients, 18 out of 28 (64.3%) exhibited enhanced atrial FAPI activity. No atrial 18F-FAPI uptake was observed in the sham beagle and healthy volunteers. In animal RA specimens, 18F-FAPI activity correlated positively with FAP mRNA (r = .98, P = .002) and protein (r = .82, P = .03) levels, as well as collagen I mRNA expression (r = .85, P = .02). B-type natriuretic peptide levels were associated with atrial 18F-FAPI activity (OR = 3.01, P = .046). CONCLUSION This proof-of-concept study suggests that 18F-FAPI PET/CT imaging may be a feasible method for evaluating activated fibroblasts in the atria of AF patients.
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Affiliation(s)
- Lina Li
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Beijing, 100020, China
| | - Jie Gao
- Department of Cardiac Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Bi-Xi Chen
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Beijing, 100020, China
| | - Xingpeng Liu
- Department of Cardiology, Cardiovascular Imaging Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Liang Shi
- Department of Cardiology, Cardiovascular Imaging Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yanjiang Wang
- Department of Cardiology, Cardiovascular Imaging Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Li Wang
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Beijing, 100020, China
| | - Yidan Wang
- Department of Cardiology, Cardiovascular Imaging Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Pixiong Su
- Department of Cardiac Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Beijing, 100020, China
| | - Min-Fu Yang
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Beijing, 100020, China
| | - Boqia Xie
- Department of Cardiology, Cardiovascular Imaging Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Beijing, 100020, China.
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Lyu Y, Bennamoun M, Sharif N, Lip GYH, Dwivedi G. Artificial Intelligence in the Image-Guided Care of Atrial Fibrillation. Life (Basel) 2023; 13:1870. [PMID: 37763273 PMCID: PMC10532509 DOI: 10.3390/life13091870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/19/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Atrial fibrillation arises mainly due to abnormalities in the cardiac conduction system and is associated with anatomical remodeling of the atria and the pulmonary veins. Cardiovascular imaging techniques, such as echocardiography, computed tomography, and magnetic resonance imaging, are crucial in the management of atrial fibrillation, as they not only provide anatomical context to evaluate structural alterations but also help in determining treatment strategies. However, interpreting these images requires significant human expertise. The potential of artificial intelligence in analyzing these images has been repeatedly suggested due to its ability to automate the process with precision comparable to human experts. This review summarizes the benefits of artificial intelligence in enhancing the clinical care of patients with atrial fibrillation through cardiovascular image analysis. It provides a detailed overview of the two most critical steps in image-guided AF management, namely, segmentation and classification. For segmentation, the state-of-the-art artificial intelligence methodologies and the factors influencing the segmentation performance are discussed. For classification, the applications of artificial intelligence in the diagnosis and prognosis of atrial fibrillation are provided. Finally, this review also scrutinizes the current challenges hindering the clinical applicability of these methods, with the aim of guiding future research toward more effective integration into clinical practice.
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Affiliation(s)
- Yiheng Lyu
- Department of Computer Science and Software Engineering, School of Physics, Mathematics and Computing, The University of Western Australia, Perth, WA 6009, Australia; (Y.L.); (M.B.)
- Harry Perkins Institute of Medical Research, The University of Western Australia, Perth, WA 6009, Australia
| | - Mohammed Bennamoun
- Department of Computer Science and Software Engineering, School of Physics, Mathematics and Computing, The University of Western Australia, Perth, WA 6009, Australia; (Y.L.); (M.B.)
| | - Naeha Sharif
- Department of Computer Science and Software Engineering, School of Physics, Mathematics and Computing, The University of Western Australia, Perth, WA 6009, Australia; (Y.L.); (M.B.)
| | - Gregory Y. H. Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool L69 3BX, UK
- Liverpool John Moores University, Liverpool L3 5UX, UK
- Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark
| | - Girish Dwivedi
- Harry Perkins Institute of Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- Department of Cardiology, Fiona Stanley Hospital, Perth, WA 6150, Australia
- Medical School, The University of Western Australia, Perth, WA 6009, Australia
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Liu D, Li Y, Zhao Q. Effects of Inflammatory Cell Death Caused by Catheter Ablation on Atrial Fibrillation. J Inflamm Res 2023; 16:3491-3508. [PMID: 37608882 PMCID: PMC10441646 DOI: 10.2147/jir.s422002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
Atrial fibrillation (AF) poses a serious healthcare burden on society due to its high morbidity and the resulting serious complications such as thrombosis and heart failure. The principle of catheter ablation is to achieve electrical isolation by linear destruction of cardiac tissue, which makes AF a curable disease. Currently, catheter ablation does not have a high long-term success rate. The current academic consensus is that inflammation and fibrosis are central mechanisms in the progression of AF. However, artificially caused inflammatory cell death by catheter ablation may have a significant impact on structural and electrical remodeling, which may affect the long-term prognosis. This review first focused on the inflammatory response induced by apoptosis, necrosis, necroptosis, pyroptosis, ferroptosis and their interaction with arrhythmia. Then, we compared the differences in cell death induced by radiofrequency ablation, cryoballoon ablation and pulsed-field ablation. Finally, we discussed the structural and electrical remodeling caused by inflammation and the association between inflammation and the recurrence of AF after catheter ablation. Collectively, pulsed-field ablation will be a revolutionary innovation with faster, safer, better tissue selectivity and less inflammatory response induced by apoptosis-dominated cell death.
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Affiliation(s)
- Dishiwen Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People’s Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, 430060, People’s Republic of China
| | - Yajia Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People’s Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, 430060, People’s Republic of China
| | - Qingyan Zhao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People’s Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, 430060, People’s Republic of China
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Li L, Hua C, Liu X, Wang Y, Zhao L, Zhang Y, Wang L, Su P, Yang MF, Xie B. SGLT2i alleviates epicardial adipose tissue inflammation by modulating ketone body-glyceraldehyde-3-phosphate dehydrogenase malonylation pathway. J Cardiovasc Med (Hagerstown) 2023; 24:232-243. [PMID: 36938811 DOI: 10.2459/jcm.0000000000001453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
AIMS Inflammation in the epicardial adipose tissue (EAT) is a contributor to atrial fibrillation. Studies have reported that sodium glucose co-transporter 2 inhibitor (SGLT2i) can alleviate EAT inflammation. However, the mechanism remains elusive. This study aims to investigate the molecular mechanism of SGLT2i in reducing EAT inflammation and to explore the effects of SGLT2i on atrial fibrosis in atrial fibrillation. METHODS Sprague-Dawley rats were injected with angiotensin II to induce atrial fibrillation and randomly assigned to receive SGLT2i ( n = 6) or vehicle ( n = 6). Macrophages (RAW264.7) were treated with ketone bodies; ACC1 knockdown/overexpression and malonyl-CoA overexpression were performed in vitro . The levels of inflammatory cytokines, ACC1, and malonyl-CoA were examined by ELISA. GAPDH malonylation was measured by co-immunoprecipitation. RESULTS In atrial fibrillation rats, SGLT2i increased the ketone body levels and decreased the expression of ACC1 and alleviated EAT inflammation and atrial fibrosis. In RAW264.7 cells, ketone bodies decreased the levels of ACC1, malonyl-CoA, and GAPDH malonylation, accompanied by reduced inflammatory cytokines. ACC1 knockdown decreased the expression of malonyl-CoA and GAPDH malonylation and alleviated lipopolysaccharide (LPS)-induced macrophage inflammation; these effects were inhibited by malonyl-CoA overexpression. Furthermore, the protective effects of ketone bodies on macrophage inflammation were abrogated by ACC1 overexpression. CONCLUSION SGLT2i alleviates EAT inflammation by reducing GAPDH malonylation via downregulating the expression of ACC1 through increasing ketone bodies, thus attenuating atrial fibrosis.
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Affiliation(s)
- Lina Li
- Department of Nuclear Medicine
| | - Cuncun Hua
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiaoyan Liu
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yidan Wang
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lei Zhao
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yeping Zhang
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Li Wang
- Department of Nuclear Medicine
| | - Pixiong Su
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | | | - Boqia Xie
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Tan W, Wang K, Yang X, Wang K, Wang N, Jiang TB. LncRNA HOTAIR promotes myocardial fibrosis in atrial fibrillation through binding with PTBP1 to increase the stability of Wnt5a. Int J Cardiol 2022; 369:21-28. [PMID: 35787431 DOI: 10.1016/j.ijcard.2022.06.073] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/02/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is one of the most common arrhythmia in clinical practice, and atrial fibrosis is the important mediator in AF. LncRNA HOTAIR was reported to be up-regulated in AF, while the underlying mechanism of HOTAIR in AF remains unclear. METHODS In vitro and in vivo AF model was established. qRT-PCR and Western blotting were used to assess the mRNA expression (HOTAIR, Wnt5a and PTBP1) and protein levels (Wnt5a, collagen I/III, α-SMA, CTGF, p-ERK, ERK, p-JNK, and JNK), respectively. MTT, CCK8, transwell assay was used to test cell viability, proliferation and migration, respectively. RIP assay assessed the correlation among HOTAIR, PTBP1 and Wnt5a. The level of α-SMA was detected by immunofluorescence. HE and Masson staining detected the histological changes and fibrosis in mouse heart tissues. RESULTS Ang II significantly increased the viability of atrial fibroblasts. The levels of HOTAIR and Wnt5a in fibroblasts were up-regulated by Ang II. HOTAIR silencing or Wnt5a significantly inhibited Ang II-induced proliferation, migration and fibrosis in fibroblasts. HOTAIR silencing repressed Wnt5a-mediated ERK and JNK signaling pathway, and Wnt5a partially abolished the effect of HOTAIR silencing on cell proliferation, migration and fibrosis. Meanwhile, HOTAIR could increase the mRNA stability of Wnt5a via recruiting PTBP1. Furthermore, HOTAIR knockdown notably inhibited the fibrosis in heart tissues of AF mice via regulation of Wnt signaling. CONCLUSION HOTAIR could promote atrial fibrosis in AF through binding with PTBP1 to increase Wnt5a stability. Our study might shed new insights on exploring new strategies against AF.
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Affiliation(s)
- Wei Tan
- Department of Cardiovascular, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, PR China; Department of Cardiovascular, Suqian First Hospital, Suqian 223800, Jiangsu Province, PR China
| | - Kun Wang
- Department of Thoracic and Cardiac Surgery, Suqian First Hospital, Suqian 223800, Jiangsu Province, PR China
| | - Xue Yang
- Department of Cardiovascular, Suqian First Hospital, Suqian 223800, Jiangsu Province, PR China
| | - Kun Wang
- Department of Cardiovascular, Suqian First Hospital, Suqian 223800, Jiangsu Province, PR China
| | - Ning Wang
- Department of Cardiovascular, Suqian First Hospital, Suqian 223800, Jiangsu Province, PR China
| | - Ting-Bo Jiang
- Department of Cardiovascular, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, PR China.
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Su Y, Chen BX, Wang Y, Li S, Xie B, Yang MF. Association of atrial 18F-fluorodeoxyglucose uptake and prior ischemic stroke in non-atrial fibrillation patients. J Nucl Cardiol 2022; 29:3194-3203. [PMID: 35083714 DOI: 10.1007/s12350-022-02903-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/23/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Atrial cardiomyopathy has gained increasing attention in the field of ischemic stroke due to its prothrombotic substrate. Timely identification of high-risk individuals without atrial fibrillation (AF) is essential in secondary prevention. We sought to explore the feasibility of atrial 18F-fluorodeoxyglucose (FDG) imaging in detecting diseased atrial substrate and in identifying ischemic stroke in a non-AF population. METHODS 1444 non-AF inpatients were initially identified. Among them, 196 patients had enhanced atrial FDG uptake, while 392 patients without atrial activity were selected as controls. Atrial activity, the history of ischemic stroke, and atrial cardiomyopathy were analyzed. RESULTS Patients with atrial cardiomyopathy had a higher prevalence of enhanced atrial activity (47.1% vs 26.0%, P < .001), and patients with increased atrial activity had a higher prevalence of a prior history of ischemic stroke (12.2% vs 3.3%, P < .001). Multivariate regression analysis demonstrated that atrial activity was independently related to ischemic stroke after adjustment for risk factors (OR 4.02, 95% CI 1.97-8.19, P < .001) and atrial cardiomyopathy (OR 3.63, 95% CI 1.51-8.74, P = .004). CONCLUSIONS This study identified an association between atrial FDG activity and a history of ischemic stroke and atrial cardiomyopathy in non-AF individuals. Further longitudinal study is warranted to demonstrate their causal relationship.
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Affiliation(s)
- Yao Su
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Chaoyang District, Beijing, 100020, China
| | - Bi-Xi Chen
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Chaoyang District, Beijing, 100020, China
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No. 185, Juqian Street, Changzhou, 213003, Jiangsu, China
| | - Sijin Li
- Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, No. 85, Jiefang Road, Taiyuan, 030001, Shanxi, China
| | - Boqia Xie
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Chaoyang District, Beijing, 100020, China.
| | - Min-Fu Yang
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Chaoyang District, Beijing, 100020, China.
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Hua C, Cai Q, Xi XY, Lin M, Wang L, Li L, Yao D, Liu X, Zhao L, Wang L, Su P, Xie B. 99mTc-sestamibi and 18F-fluorodeoxyglucose imaging in patients with cardiogenic shock: A pilot study. Front Cardiovasc Med 2022; 9:1047577. [DOI: 10.3389/fcvm.2022.1047577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
BackgroundWhether perfusion/metabolism imaging differs between matched ST-segment elevation myocardial infarction (STEMI) patients with and without cardiogenic shock (CS) remains unknown.MethodsSeventeen STEMI patients with CS (13 men, 60 ± 12 years) and 16 matched STEMI patients without CS (15 men, 54 ± 15 years) were prospectively recruited. All patients underwent baseline 99mTc-sestamibi/18F-fluorodeoxyglucose (FDG) imaging and echocardiography 6 ± 2 days post-infarction. Nine patients with CS and seven without CS had repeated imaging 98 ± 7 days post-infarction. The total perfusion deficit (TPD) and total FDG uptake deficit (TFD) were calculated to assess the percentages of impaired perfusion and metabolism over the left ventricle. Patients were followed up for 337 days (213–505 days) and the major adverse cardiac events (MACE) were recorded.ResultsTPD was greater in patient with CS and was independently related to the presence of CS (OR: 4.36, p = 0.013). Both acute- and convalescent TFD were inversely related to the improvement ratio of LVEF (r-values: −0.62, −0.73; both p < 0.05). MACE occurred in 16 patients (10 CS and 6 non-CS), and acute TFD was predictive of MACE in those with CS (HR: 2.06, p = 0.038).ConclusionIn this pilot study, we demonstrated that STEMI patients with CS had a significantly increased TPD, which was relevant to the presence of CS. Acute TFD was associated with improvement in LVEF, and was predictive of MACE in patients with CS.
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Chen BX, Xie B, Zhou Y, Shi L, Wang Y, Zeng L, Liu X, Yang MF. Association of Serum Biomarkers and Cardiac Inflammation in Patients With Atrial Fibrillation: Identification by Positron Emission Tomography. Front Cardiovasc Med 2021; 8:735082. [PMID: 34712708 PMCID: PMC8546267 DOI: 10.3389/fcvm.2021.735082] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/16/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Peripheral biomarkers may be affected by various factors, their reliability in reflecting local cardiac inflammatory status in patients with atrial fibrillation (AF) needs further exploration. This prospective study was aimed to investigate the relationship between circulating biomarkers and local cardiac inflammation measured by epicardial adipose tissue (EAT) activity via18F-fluorodeoxyglucose (FDG) imaging in AF patients. Methods: From 2017 to 2018, 83 AF patients [43 persistent AF (PsAF) and 40 paroxysmal AF (PAF)] referred for radiofrequency catheter ablation (RFCA) were recruited. Pre- and post-RFCA blood samples were collected to measure IL-6, IL-8, IL-10, IL-18, TNF-α, Hsp27, Hsp60, Hsp70, PDGF-BB, MMP-2, MMP-9, MPO, TGF-β1, Gal-3, and sST2. Pre-RFCA FDG images were obtained to assess EAT activity. Sixty-seven patients (35 PAF and 32 PsAF) received RFCA were regularly followed for 27 (24, 29) months. Results: Higher hsCRP and IL-6 and lower TGF-β1 were demonstrated in PsAF patients compared with PAF patients. Multivariate logistic regression analysis demonstrated that Gal-3 (OR: 1.221, 95% CI: 1.024–1.456, P = 0.026) and MPO (OR: 1.002, 95% CI: 1.001–1.003, P = 0.027) were independently correlated with EAT activity. The percentage decrease of Hsp60 linearly correlated with that of EAT activity post-RFCA (Spearman rs = 0.455, P = 0.019). Seventeen patients (10 PsAF and 7 PAF) had AF recurrence, but none of the selected biomarkers were predictive of post-RFCA recurrence. Conclusion: Our findings demonstrated that in patients with AF, Gal-3 correlated with local cardiac inflammation, and Hsp60 was associated with the alleviation of cardiac inflammation after RFCA.
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Affiliation(s)
- Bi-Xi Chen
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Boqia Xie
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yang Zhou
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Liang Shi
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yanjiang Wang
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lijun Zeng
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xingpeng Liu
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Min-Fu Yang
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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van der Bijl P, van Rosendael A, Bax JJ. Atrial positron emission tomography in atrial fibrillation: predicting radiofrequency catheter ablation success. Eur Heart J Cardiovasc Imaging 2021; 23:113-114. [PMID: 34151943 DOI: 10.1093/ehjci/jeab113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Pieter van der Bijl
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Alexander van Rosendael
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
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