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Association of atrial 18F-fluorodeoxyglucose uptake and prior ischemic stroke in non-atrial fibrillation patients

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Journal of Nuclear Cardiology Aims and scope

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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Abbreviations

AF:

Atrial fibrillation

FDG:

Fluorodeoxyglucose

PET/CT:

Positron emission tomography/computed tomography

SUV:

Standardized uptake value

PTFV1:

P-wave terminal force in lead V1

LAVI:

Left atrium volume index

BNP:

B-type natriuretic peptide

NT-proBNP:

N-terminal proBNP

ROI:

Region of interest

TBR:

Target-to-background ratio

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Funding

This work was supported by the National Natural Science Foundation of China (81871380) and Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (ZYLX202105).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Chaoyang District, Beijing, 100020, China

    Yao Su, Bi-Xi Chen & Min-Fu Yang

  2. Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No. 185, Juqian Street, Changzhou, 213003, Jiangsu, China

    Yuetao Wang

  3. Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, No. 85, Jiefang Road, Taiyuan, 030001, Shanxi, China

    Sijin Li

  4. Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Chaoyang District, Beijing, 100020, China

    Boqia Xie

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  1. Yao Su
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Correspondence to Boqia Xie or Min-Fu Yang.

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Su, Y., Chen, BX., Wang, Y. et al. Association of atrial 18F-fluorodeoxyglucose uptake and prior ischemic stroke in non-atrial fibrillation patients. J. Nucl. Cardiol. 29, 3194–3203 (2022). https://doi.org/10.1007/s12350-022-02903-y

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  • DOI: https://doi.org/10.1007/s12350-022-02903-y

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