The characterization and prognostic significance of right ventricular glucose metabolism in non-ischemic dilated cardiomyopathy

In dilated cardiomyopathy (dcm), there are limited data on right ventricular (rv) glucose metabolism assessed by [18f]fludeoxyglucose positron emission tomography (18f-fdg pet) imaging. we aimed to characterize rv glucose metabolism and investigate the prognostic significance of rv fdg uptake in dcm. 18f-fdg pet imaging and cardiac magnetic resonance imaging (mri) were performed in 63 consecutive dcm patients within an interval of 3-7 days. there was a significant correlation between rvef and rv fdg uptake whether corrected rv standard uptake value (crvsuv) (r = −0.571, p < .001) or the relative rv fdg uptake determined as the ratio of rv to left ventricular (lv) corrected suv (cr/l) (r = −0.405, p < .001) was used. during a median follow-up period of 804 days, 15 patients (23.8%) reached the primary endpoint of all-cause mortality or heart transplantation. on univariate cox analysis, crvsuv > 7.01 and cr/l > 0.795 were significantly associated with the overall survival (hazard ratio [hr] 5.415, 95% confidence interval [ci] 1.945-15.078, p < .001; hr 6.422, 95% ci 2.250-18.332, p < .001). patients with increased rv fdg uptake had a worse outcome (crvsuv > 7.01 vs crvsuv ≤ 7.01, log-rank 13.085, p < .001; cr/l > 0.795 vs cr/l ≤ 0.795, log-rank 15.695, p < .001). on multivariate analysis, cr/l > 0.795 remained a significant independent predictor of the endpoint (hr 5.001, 95% ci 1.641-15.239, p = .004), while crvsuv > 7.01 showed no significance (hr 2.611; 95% ci 0.797-8.558; p = .113). increased rv fdg uptake was associated with rv dysfunction and be a prognostic predictor of all-cause mortality or heart transplantation in patients with dcm.