Assessment of the metabolic heart-brain axis with cardiac and brain 18F-FDG PET/CT imaging in patients with heart failure

91 Objectives: In this study, we aimed to evaluate the cerebral metabolism in patients with heart failure (HF) to determine the correlation between myocardial phenotypic characterization and cerebral metabolic activity. Methods: Eighty-three HF patients were prospectively enrolled. All participants underwent gated 99mTc-sestamibi single photon emission computed tomography (SPECT)/CT myocardial perfusion imaging, also cardiac and cerebral 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT. Fifteen healthy volunteers underwent cerebral FDG PET/CT imaging served as controls. Patients were stratified by extent of hibernating myocardium (HM) and left ventricular ejection fraction (LVEF) into 3 subgroups, group1: HM < 10% (n = 33); group2: HM ≥ 10%, LVEF < 25% (n = 34); group3: HM ≥ 10%, 25% ≤ LVEF ≤ 40% (n = 16). Cerebral metabolism expressed as the standardized uptake value (SUV) in the whole brain (SUVwhole-brain) and the SUV ratios (SUVR) corrected by cerebellar activity in 24 cognition related brain regions were determined. The relationship between cardiac imaging features and brain metabolism was assessed. Differences in brain metabolism between 3 subgroups of the patients and healthy volunteers were compared. Results: The SUVwhole-brain (r = 0.28, P 0.05). In comparison to volunteers, SUVRs (frontal areas) in group 3 were relatively elevated, whereas SUVRs (hippocampus and para-hippocampus) in group1 were significantly reduced (P < 0.05). SUVRs (frontal areas) in group 1 were significantly lower than group3 (P < 0.05). Conclusions: The global and regional brain metabolic activity was significantly associated with the extent of HM and cardiac function in HF patients. The findings of this study might contribute to the physiopathological interpretation of cognitive impairment in patients with HF.