Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Σοφία Χατζηιωάννου, Καθηγήτρια, Iατρική Σχολή, ΕΚΠΑ
Νικόλαος Κελέκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Παρίσης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Φιλιππάτος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιγνάτιος Οικονομίδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Εμμανουήλ Ρίζος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χαράλαμπος Παπαγεωργίου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Έλεγχος με ποζιτρονική τομογραφία του μεταβολισμού του εγκεφαλικού παρεγχύματος σε ασθενείς με διατατική μυοκαρδιοπάθεια
Translated title:
Brain glucose metabolism in heart failure patients by 18F-FDG PET/CT
Summary:
Aims: Depression is an important issue in heart failure (HF). The study investigated whole-brain and regional-brain glucose metabolism in HF patients and its association with depression comorbidity.
Methods and results: Twenty-nine hospitalized patients with symptomatic systolic HF disease (LVEF<40%), NYHA class II-IV and mean age of 55.5±12.0 years, had psychometric questionnaires before discharge and an 18F-FDG PET/CT brain scan after discharge. Semi-automated image analysis was performed on all cases and 30 matched controls. The metabolic parameter SUVmean was calculated for the whole-brain and three brain regions, implicated in depression pathogenesis. A standardized SUVmean was also estimated by dividing regional-brain SUVmean with the whole-brain SUVmean.
Cases had lower average whole-brain SUVmean (3.90±1.49 vs 5.10±1.35, p=0.001) and average regional-brain SUVmean (4.57±2.31 vs 9.96±3.58, p<0.001) compared to controls.
Whole-brain SUVmean had a statistically significant correlation to patient age, NYHA class, diabetes comorbidity, creatinine levels, depression, and cognitive impairment. Regional-brain SUVmean was correlated to whole-brain SUVmean and depression. The standardized SUVmean, in particular, was found to be a robust index that could differentiate HF patients with “epiphenomenal” (>0.93) or “real” (≤0.93) depression.
Conclusion: HF patients with more severe disease showed whole-brain and regional-brain hypometabolism in 18F-FDG PET/CT.
Depressed HF patients (Beck Depression Inventory score >13) exhibited different metabolic patterns that could be used to differentiate between “epiphenomenal” and “real” depression. Namely, presence of whole-brain hypometabolism suggested “epiphenomenal” depression while absence suggested “real” depression. Presence of significant relative, regional hypometabolism enhanced the likelihood of “real” depression diagnosis.
Main subject category:
Health Sciences
Keywords:
Brain glucose metabolism, 18-F FDG PET/CT, Heart failure, Depression
Number of references:
189
