| Objective:To evaluate the left ventricular(LV)function after transcatheter closure of patent ductus arteriosus(PDA)in adults with severe pulmonary arterial hypertension(PAH)and identify the potential predictors.Methods:This retrospective study enrolled the adult patients with PDA and severe PAH who underwent successful transcatheter closure between November 2005 and November 2014.During right heart catheterization,all patients had mean pulmonary arterial pressure≧50 mmHg with pulmonary vascular resistance index ≦ 8WU·m2.LV function was followed up after closure of PDA.Multivariate logistic analysis was used to identify the potential predictors of postoperative LV dysfunction.Results:Of the 41 included patients(age:37.1 ± 14.2 years,male:19.5%),the size of PDA was 8.9±2.9 mm,left ventricular end diastolic dimension was 63.3±9.3mm,left ventricular ejection fraction was 60.2±7.9%,mean pulmonary arterial pressure was 65.3± 11.2 mmHg,pulmonary vascular resistance index was 4.7±1.9 WU·m2,and the median pulmonary to systemic flow ratio was 2.5(1.8,3.2).After closure of PDA,mean pulmonary arterial pressure decreased to 27.2±6.2 mmHg(P<0.01).Twelve(29%)patients had postoperative LV dysfunction,among which 9(75%)recovered during follow up(median,6 months[1,24]months).Multivariate logistic regression analysis suggested that preoperative left ventricular end diastolic dimension was an independent predictor of postoperative LV dysfunction(odds ratio=1.299,95%confidence interval:1.069-1.579,P=0.009).Conclusion:In nearly 1/3 of adult patients with PDA and severe PAH,LV dysfunction occurred after transcatheter closure and most of them gradually returned to normal.Preoperative left ventricular end diastolic dimension was an independent predictor of postoperative LV dysfunction.Objective:To preliminarily characterize cardiac uptake and explore the clinical value of 68Ga-labeled fibroblast activator inhibitor(68Ga-FAPI)PET/CT imaging in patients with hypertrophic cardiomyopathy(HCM).Methods:Five patients(3 males;61 ± 6 years)diagnosed with HCM were prospectively enrolled to undergo 68Ga-FAPI PET/CT imaging.The maximum standardized uptake value(SUVmax)was obtained for left ventricular myocardium and blood pool(left atrium)and the difference between myocardium and blood pool was calculated by Student’s t test.All patients underwent cardiac magnetic resonance(CMR)to determine the wall thickness and the presence of LGE.By a 17-segment model,cardiac uptake of 68Ga-FAPI was compared with presence of LGE on a segmental basis by Chisquare Test.Results:All patients exhibited significantly increased uptake of 68Ga-FAPI in left ventricular myocardium relative to blood pool(SUVmax:8.83 ± 2.72 vs 1.11 ± 0.12,P=0.003)and all presented with LGE.The distribution of 68Ga-FAPI uptake exceeded LGE presence among segments(n=85)(P<0.001).Segments with 68Ga-FAPI uptake but absence of LGE localized in peri-LGE regions.Moreover,the intensity of 68Ga-FAPI in transmural LGE segments seemed to be lower than that with focal or patchy LGE.Conclusions:68Ga-FAPI PET/CT directly shows fibroblast activation in HCM and 68Ga-FAPI uptake area beyond the LGE region,suggesting the potential for early detection of fibrotic remodeling. |
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