Persistent somatostatin PET signs of inflammatory cells 4 to 5 months after acute myocarditis are linked to a poorer recovery of cardiac function

IF 8.6 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Journal of Nuclear Medicine and Molecular Imaging Pub Date : 2025-03-22 DOI:10.1007/s00259-025-07202-5

Thomas Larive, Caroline Boursier, Marine Claudin, Jeanne Varlot, Laura Filippetti, Olivier Huttin, Véronique Roch, Laetitia Imbert, Matthieu Doyen, Antoine Fraix, Damien Mandry, Elodie Chevalier, Pierre-Yves Marie

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Abstract

Purpose

Acute Myocarditis (AM) was recently shown to be detected by the Somatostatin Positron Emission Tomography (PET) criterion of > 18 cm³ Myocardial Uptake Volume (MUV), a sign of significant inflammatory cell infiltration. This study characterizes patients for whom this criterion persists 4 to 5 months after AM.

Methods

Cardiac Magnetic Resonance (CMR) and [⁶⁸ Ga]Ga-DOTA-TOC PET data from 27 AM patients (2 women, median age 26.5 years [interquartile range: 21.9–31.9]) were analyzed at the acute phase and at a 4.5 [4.3–5.0] month follow-up.

Results

Eleven AM patients (41%) still had > 18 cm³ MUV at the follow-up (PET +). The left ventricular ejection fraction (LVEF) was correlated with MUV at baseline (p = 0.011) and follow-up (p = 0.001) and was lower at follow-up in PET + (52.9 [48.6; 55.0] %) than in the other patients (56.0 [54.3; 57.8] %, p = 0.001). However, this poorer recovery of the PET + LVEF was associated with two MUV evolution profiles evocative of different mechanisms: (i) a prolonged active disease in the 5 PET + patients for whom the MUV increased at follow-up, in association with a slight decrease in LVEF (p = 0.08), and (ii) a more severe initial insult in the 6 other PET + patients for whom the MUV decreased at follow-up with concomitant increases in LVEF (p = 0.028) but these improvements started from much worse baseline LVEF and MUV (respectively, p = 0.022 and 0.003 vs. the other patients).

Conclusions

Somatostatin PET monitoring of AM unveils numerous patients with signs of a persistent inflammatory cell infiltrate 4 to 5 months after acute myocarditis. This persistence is associated with poorer recovery of cardiac function and is seemingly due to active inflammation that is either more severe at baseline or continues to expand over the following months.

Trial registration number: NCT03347760 on clinicaltrials.gov.

Registration date: 22–11-2017.

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来源期刊

European Journal of Nuclear Medicine and Molecular Imaging 医学-核医学

CiteScore

15.60

自引率

9.90%

发文量

392

审稿时长

3 months

期刊介绍： The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.