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FDG atrial uptake is associated with an increased prevalence of stroke in patients with atrial fibrillation

  • Mathieu SinigagliaEmail author
  • Besma Mahida
  • Eve Piekarski
  • Renata Chequer
  • Nidaa Mikail
  • Khadija Benali
  • Fabien Hyafil
  • Dominique Le Guludec
  • François Rouzet
Original Article

Abstract

Purpose

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with an increased risk of stroke. Indeed, silent AF is frequently identified in unexplained ischemic stroke. 18F-FDG-PET/CT is a powerful tool for assessing myocardial metabolic shift and inflammation, both potentially at stake in AF. This case–control study investigated whether AF could promote FDG uptake in atria after physiological myocardial glucose uptake suppression, and the potential relationship between FDG atrial uptake and prevalence of stroke.

Methods

We retrospectively enrolled 128 patients (64 consecutive patients with AF and 64 without AF as the control group, matched for age and sex) who underwent 18F-FDG-PET/CT after a high-fat low-carbohydrate diet. We analyzed visual and quantitative FDG uptake parameters of the right and left atria (RA/LA) and the right and left appendages (RAA/LAA), and selected clinical features including history of stroke.

Results

Diffuse right atrial uptake was present in a third of patients with AF and only two patients in the control group. FDG uptake intensity of both atria was significantly associated with the underlying heart rhythm. The occurrence of stroke was strongly associated with detectable atrial uptake in multivariate analysis, with an odds ratio superior to that of other known risk factors.

Conclusions

This study shows a significant correlation between FDG atrial uptake and AF. While inconsistent, this pattern seems to be associated with an increased prevalence of cardioembolic stroke.

Keywords

Atrial fibrillation Stroke Positron emission tomography (PET) FDG Inflammation 

Notes

Acknowledgements

No funding was received for this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval and consent

The institutional review board of Bichat Hospital approved this study, and all subjects gave informed consent for review of their records.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Mathieu Sinigaglia
    • 1
    • 2
    • 3
    Email author
  • Besma Mahida
    • 1
    • 2
    • 3
  • Eve Piekarski
    • 1
    • 2
    • 3
    • 4
  • Renata Chequer
    • 1
    • 2
    • 3
  • Nidaa Mikail
    • 1
    • 2
    • 3
  • Khadija Benali
    • 1
    • 2
    • 3
  • Fabien Hyafil
    • 1
    • 2
    • 3
    • 4
  • Dominique Le Guludec
    • 1
    • 2
    • 3
    • 4
  • François Rouzet
    • 1
    • 2
    • 3
    • 4
  1. 1.Nuclear Medicine DepartmentBichat-Claude Bernard Hospital, AP-HPParisFrance
  2. 2.University Paris-DiderotParisFrance
  3. 3.Inserm UMR-S 1148ParisFrance
  4. 4.Département Hospitalo-Universitaire (DHU) FIRE, Inserm 1148 (LVTS)Université Paris DiderotParis 7France

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