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Test–retest repeatability of myocardial oxidative metabolism and efficiency using standalone dynamic 11C-acetate PET and multimodality approaches in healthy controls

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Myocardial efficiency measured by 11C-acetate positron emission tomography (PET) has successfully been used in clinical research to quantify mechanoenergetic coupling. The objective of this study was to establish the repeatability of myocardial external efficiency (MEE) and work metabolic index (WMI) by non-invasive concepts.

Methods and Results

Ten healthy volunteers (63 ± 4 years) were examined twice, one week apart, using 11C-acetate PET, cardiovascular magnetic resonance (CMR), and echocardiography. Myocardial oxygen consumption from PET was combined with stroke work data from CMR, echocardiography, or PET to obtain MEE and WMI for each modality. Repeatability was estimated as the coefficient of variation (CV) between test and retest. MEECMR, MEEEcho, and MEEPET values were 21.9 ± 2.7%, 16.4 ± 3.7%, and 23.8 ± 4.9%, respectively, P < .001. WMICMR, WMIEcho, and WMIPET values were 4.42 ± 0.90, 4.07 ± 0.63, and 4.58 ± 1.13 mmHg × mL/m2 × 106, respectively, P = .45. Repeatability for MEECMR was superior compared with MEEEcho but did not differ significantly compared with MEEPET (6.3% vs 12.9% and 9.4%, P = .04 and .25). CV values for WMICMR, WMIEcho, and WMIPET were 10.0%, 14.8%, and 12.0%, respectively, (P = .53).

Conclusions

Non-invasive measurements of MEE using 11C-acetate PET are highly repeatable. A PET-only approach did not differ significantly from CMR/PET and might facilitate further clinical research due to lower costs and broader applicability.

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Abbreviations

CMR:

Cardiovascular magnetic resonance

FSV:

Forward stroke volume

GSV:

Geometrical stroke volume

HR:

Heart rate

LV:

Left ventricle

MAP:

Mean arterial blood pressure

MEE:

Myocardial external efficiency

MVO2 :

Myocardial oxygen consumption

SV:

Stroke volume

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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: Novo Nordisk, MSD, Bayer, Daiichi-Sankyo, Novartis, Sanofi-Aventis, and Pfizer. For Nils Henrik Hansson, Johannes Hendrik Harms, Lars Poulsen Tolbod, Won Yong Kim, Roni Nielsen, Jorgen Frokiaer, Kirsten Bouchelouche, Steen Hvitfeldt Poulsen, Erik Thorlund Parner, and Jens Sorensen there are no disclosures.

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Authors and Affiliations

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

    Nils Henrik Hansson MD, PhD, Won Yong Kim MD, DMSc, Roni Nielsen MD, PhD, Steen Hvitfeldt Poulsen MD, DMSc & Henrik Wiggers MD, DMSc

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

    Hendrik Johannes Harms PhD, Lars P. Tolbod PhD, Jørgen Frøkiær MD, DMSc, Kirsten Bouchelouche MD, DMSc & Jens Sörensen MD, DMSc

  3. Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark

    Erik Thorlund Parner PhD

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  1. Nils Henrik Hansson MD, PhD
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Correspondence to Nils Henrik Hansson MD, PhD.

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Funding

This study was funded by the Lundbeck Foundation, the Arvid Nilssons Foundation, the Health Research Fund of Central Denmark Region, Karen Elise Jensens Foundation, and Snedkermester Sophus Jacobsen and Hustru Astrid Jacobsens Foundation.

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Hansson, N.H., Harms, H.J., Kim, W.Y. et al. Test–retest repeatability of myocardial oxidative metabolism and efficiency using standalone dynamic 11C-acetate PET and multimodality approaches in healthy controls. J. Nucl. Cardiol. 25, 1929–1936 (2018). https://doi.org/10.1007/s12350-018-1302-z

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