Abstract
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Objectives To evaluate the variation of cardiac adrenergic activity in patients with idiopathic heart failure disease (NYHA III-IV) after CRT using 11C hydroxyephedrine (11C-HED) PET/CT.
Methods In our prospective study we evaluated eleven patients with idiopathic Heart Failure Disease (mean age=68; range=55-81) already scheduled for the implantation of a resynchronization device. All patients underwent four 11C-HED PET/CT studies as following: PET1 after the implantation of resynchronization device but before its switching on; PET2 one week after PET1 with switched on device; PET 3 and PET 4 during FU (about 6 months after) with switched on and switched off device respectively. The study was performed 10 minutes after iv injection of 11C-HED (370-555 MBq). Using a polar map approach, we automatically calculated global cardiac retention (GCR) of 11C-HED normalised to the injected dose (total counts/MBq). Patients were divided in responders (R) and non-responders (NR) to CRT during FU using clinical parameters and LVFE value obtained by echocardiography (R:LVFE>30%; NR: LVFE<30%).
Results Patients were divided into: 8 R and 3 NR. Mean values of 11C-HED retention of PET1, PET2, PET3 and PET4 in R and NR pts were summarized as following: PET1: R ( 2,00E+03 tot counts/MBq); NR (1,13E+03 tot counts/MBq). PET2: R (7,19E+02 tot counts/MBq); NR (3,87E+02 tot counts/MBq). PET3: R (8,15E+02 tot counts/MBq); NR (1,45E+03 tot counts/MBq). PET4: R (6,63E+02 tot counts/MBq); NR (1,74E+03 tot counts/MBq). A 11C-HED GCR decrease in PET2 means a good response to CRT in both R and NR. However, during FU, R group showed a significant decrease in 11C-HED retention, while NR group an increase in 11C-HED retention.
Conclusions 11C-HED PET/CT seems to be an helpful non invasive method to monitory CRT response. However its cost and unavailability seem not address to a routinely use
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