PET-CT Imaging in Hypertrophic Cardiomyopathy: A Narrative Review on Risk Stratification and Prognosis.

Area of Science:

• Cardiovascular Imaging
• Nuclear Cardiology
• Cardiomyopathy Research

Background:

• Hypertrophic cardiomyopathy (HCM) presents challenges in accurately stratifying sudden cardiac death (SCD) risk.
• Microvascular dysfunction, ischemia, and metabolic changes in HCM are linked to disease progression and adverse outcomes.
• Myocardial fibrosis and fibroblast activation are key factors in HCM progression.

Purpose of the Study:

• To review the role of cardiac PET-CT imaging in understanding HCM progression.
• To evaluate PET's utility in risk stratification for SCD in HCM patients.
• To explore PET's potential in monitoring therapeutic responses in HCM.

Main Methods:

• Utilizing Positron Emission Tomography (PET) to assess myocardial blood flow (MBF).
• Employing fluorodeoxyglucose (FDG) uptake to evaluate myocardial metabolism.
• Evaluating fibroblast activation using PET imaging for fibrosis assessment.

Main Results:

• PET can identify microvascular dysfunction, ischemia, and altered metabolism in HCM.
• Abnormal MBF and increased FDG uptake may correlate with increased SCD risk.
• PET imaging offers insights into myocardial fibrosis and fibroblast activation.

Conclusions:

• Cardiac PET-CT imaging provides valuable insights into HCM pathophysiology and progression.
• Further research is needed to confirm PET's role in enhancing SCD risk stratification for HCM.
• PET imaging holds potential for monitoring treatment efficacy and patient prognosis in HCM.