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Evaluation of ECG-gated [11C]acetate PET for measuring left ventricular volumes, mass, and myocardial external efficiency

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

An Erratum to this article was published on 11 May 2016

Abstract

Background

Noninvasive estimation of myocardial external efficiency (MEE) requires measurements of left ventricular (LV) oxygen consumption with [11C]acetate PET in addition to LV stroke volume and mass with cardiovascular magnetic resonance (CMR). Measuring LV geometry directly from ECG-gated [11C]acetate PET might enable MEE evaluation from a single PET scan. Therefore, we sought to establish the accuracy of measuring LV volumes, mass, and MEE directly from ECG-gated [11C]acetate PET.

Methods

Thirty-five subjects with aortic valve stenosis underwent ECG-gated [11C]acetate PET and CMR. List mode PET data were rebinned into 16-bin ECG-gated uptake images before measuring LV volumes and mass using commercial software and compared to CMR. Dynamic datasets were used for calculation of mean LV oxygen consumption and MEE.

Results

LV mass, volumes, and ejection fraction measured by CMR and PET correlated strongly (r = 0.86-0.92, P < .001 for all), but were underestimated by PET (P < .001 for all except ESV P = .79). PET-based MEE, corrected for bias, correlated fairly with PET/CMR-based MEE (r = 0.60, P < .001, bias −3 ± 21%, P = .56). PET-based MEE bias was strongly associated with LV wall thickness.

Conclusions

Although analysis-related improvements in accuracy are recommended, LV geometry estimated from ECG-gated [11C]acetate PET correlate excellently with CMR and can indeed be used to evaluate MEE.

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Abbreviations

MEE:

Myocardial external efficiency

CMR:

Cardiovascular magnetic resonance

MVO2 :

Myocardial oxygen consumption

LV MVO2 :

Left ventricle total oxygen consumption

ECTb:

Emory cardiac toolbox

ΔAVmean :

Mean transaortic valve gradient

MEECMR :

MEE calculated using both PET and CMR data

MEEPET :

MEE calculated using PET data only

cMEEPET :

MEE calculated from PET data only using SV and mass corrected according to the derived linear regression equation for PET and CMR values

WMI:

Work metabolic index

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Acknowledgment

Authors thank cardiologist Inger Sihm at Aarhus Hjerteklinik and The Department of Cardiology at the Regional Hospital in Horsens, Denmark for assisting in subject recruitment. We also thank Anders Jorsal, Bent Roni Ranghøj Nielsen and Peter Iversen for their assistance during protocol preparation.

Disclosure

This study received financial assistance from the Lundbeck Foundation, Arvid Nilssons Foundation, Karen Elise Jensens Foundation and Snedkermester Sophus Jacobsen & Hustru Astrid Jacobsens Foundation. Henrik Wiggers is principal investigator in studies involving the following pharmaceutical companies; NovoNordisk, MSD, Bayer, Daiichi-Sankyo, Novartis, Sanofi-Aventis, Pfizer. For Nils Henrik Stubkjaer Hansson, Johannes Hendrik Harms, Lars Poulsen Tolbod, Won Yong Kim, Esben Sovso Szocska Hansen, Tomas Zaremba, Steen Jakobsen, Jorgen Frokiaer and Jens Sorensen, there are no disclosures.

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Authors and Affiliations

  1. Department of Cardiology, Aarhus University Hospital, Aarhus C, Denmark

    Nils Henrik Hansson MD, Henrik Wiggers MD, DMSc, Won Yong Kim MD, DMSc & Tomas Zaremba MD, PhD

  2. Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Aarhus C, Denmark

    Lars Tolbod PhD, Johannes Harms PhD, Jørgen Frøkiær MD, DMSc, Steen Jakobsen PhD & Jens Sørensen MD, DMSc

  3. MR Research Centre, Aarhus University Hospital, Aarhus C, Denmark

    Won Yong Kim MD, DMSc & Esben Hansen Msc

  4. Danish Diabetes Academy, Odense, Denmark

    Esben Hansen Msc

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  1. Nils Henrik Hansson MD
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  2. Lars Tolbod PhD
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  4. Henrik Wiggers MD, DMSc
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Correspondence to Nils Henrik Hansson MD.

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Hansson, N.H., Tolbod, L., Harms, J. et al. Evaluation of ECG-gated [11C]acetate PET for measuring left ventricular volumes, mass, and myocardial external efficiency. J. Nucl. Cardiol. 23, 670–679 (2016). https://doi.org/10.1007/s12350-015-0331-0

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  • DOI: https://doi.org/10.1007/s12350-015-0331-0

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