Evaluation of right ventricular myocardial metabolism and pulmonary vascular remodeling in pulmonary arterial hypertension by positron emission tomography
Pulmonary arterial hypertension (PAH) is a rare and severe form of pulmonary hypertension, which is characterized by pulmonary vascular remodeling, as well as metabolic and functional alterations in the right ventricular myocardium. The proven metabolic shift towards anaerobic glycolysis in the heart and lungs can be quantitatively and qualitatively evaluated with a molecular imaging technique — 2-[18F] fluoro-2-deoxy-Dglucose (FDG) positron emission tomography (PET). This review is devoted to the analysis of foreign scientific publications. There are presented research results that prove the diagnostic value of fused PET/computer tomography (CT) (PET/CT) images with FDG and other promising radiopharmaceuticals in patients with PAH. This tool allows estimation of the severity of the disease, to determine the clinical prognosis and monitor the effectiveness of treatment in each case. Furthermore, the methods of molecular visualization allow the analysis of the PAH pathogenesis and description of the new biologic targets, such as development factors of endothelial dysfunction and remodeling of pulmonary vasculature.