Left Atrial Glucose Metabolism Evaluation by 18F-FDG-PET in Persistent Atrial Fibrillation and in Sinus Rhythm

Sébastien Marchandise; Véronique Roelants; Tristan Raoult; Quentin Garnir; Christophe Scavée; Varnavas Varnavas; Aurélien Wauters; Damien Gruson; Eric Nellessen; Michel Hesse; Christophe Beauloye; Bernhard L Gerber

doi:10.1016/j.jacbts.2023.11.001

Left Atrial Glucose Metabolism Evaluation by ¹⁸F-FDG-PET in Persistent Atrial Fibrillation and in Sinus Rhythm

JACC Basic Transl Sci. 2024 Jan 17;9(4):459-471. doi: 10.1016/j.jacbts.2023.11.001. eCollection 2024 Apr.

Authors

Sébastien Marchandise^{1

2}, Véronique Roelants^{3

4}, Tristan Raoult^{1

2}, Quentin Garnir¹, Christophe Scavée^{1

2}, Varnavas Varnavas^{1

2}, Aurélien Wauters^{1

2}, Damien Gruson^{1

2}, Eric Nellessen^{1

2}, Michel Hesse^{3

4}, Christophe Beauloye^{1

2}, Bernhard L Gerber^{1

2}

Affiliations

¹ Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium.
² Pôle de Recherche Cardiovasculaire (CARD), Université Catholique de Louvain, Brussels, Belgium.
³ Division of Nuclear Medicine, Cliniques Universitaires St. Luc, Brussels, Belgium.
⁴ Pole Molecular Imaging, Radiotherapy & Oncology (MIRO), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.

Abstract

The role of atrial metabolism alterations for initiation and atrial fibrillation (AF) persistence remains poorly understood. Therefore, we evaluated left atrial glucose metabolism by nicotinic acid derivative stimulated 18-fluorodeoxyglucose positron emission tomography in 36 patients with persistent AF undergoing catheter ablation before and 3 months after return to sinus rhythm and compared values against healthy controls. Under identical hemodynamics and metabolic conditions, and although left ventricular FDG uptake remained unchanged, patients in persistent AF presented significantly higher total left atrial and left atrial appendage uptake, which decreased significantly after return to sinus rhythm, despite improvement of passive and active atrial contractile function. These findings support a role of altered glucose metabolism and metabolic wasting underlying the pathophysiology of persistent AF.

Keywords: FDG-PET; atrial cardiomyopathy; atrial fibrillation; glucose metabolism.