دورية أكاديمية

18 F-FDG PET/CT in left ventricular assist device infections: In-depth characterization and clinical implications.

التفاصيل البيبلوغرافية
العنوان: 18 F-FDG PET/CT in left ventricular assist device infections: In-depth characterization and clinical implications.
المؤلفون: Devesa A; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Mount Sinai Fuster Heart Hospital, New York, New York; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain., Rashed E; Mount Sinai Fuster Heart Hospital, New York, New York., Moss N; Mount Sinai Fuster Heart Hospital, New York, New York., Robson PM; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Pyzik R; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Roldan J; Mount Sinai Fuster Heart Hospital, New York, New York., Taimur S; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York., Rana MM; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York., Ashley K; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Young A; Mount Sinai Fuster Heart Hospital, New York, New York., Patel G; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York., Mahmood K; Mount Sinai Fuster Heart Hospital, New York, New York., Mitter SS; Mount Sinai Fuster Heart Hospital, New York, New York., Lala A; Mount Sinai Fuster Heart Hospital, New York, New York., Barghash M; Mount Sinai Fuster Heart Hospital, New York, New York., Fox A; Mount Sinai Fuster Heart Hospital, New York, New York., Correa A; Mount Sinai Fuster Heart Hospital, New York, New York., Pirlamarla P; Mount Sinai Fuster Heart Hospital, New York, New York., Contreras J; Mount Sinai Fuster Heart Hospital, New York, New York., Parikh A; Mount Sinai Fuster Heart Hospital, New York, New York., Mancini D; Mount Sinai Fuster Heart Hospital, New York, New York., Jacobi A; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York., Ghesani N; Division of Nuclear Medicine, Icahn School of Medicine at Mount Sinai, New York, New York., Gavane SC; Division of Nuclear Medicine, Icahn School of Medicine at Mount Sinai, New York, New York., Ghesani M; Division of Nuclear Medicine, Icahn School of Medicine at Mount Sinai, New York, New York., Itagaki S; Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York., Anyanwu A; Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York., Fayad ZA; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Trivieri MG; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Mount Sinai Fuster Heart Hospital, New York, New York. Electronic address: Mariagiovanna.trivieri@mountsinai.org.
المصدر: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2024 Apr; Vol. 43 (4), pp. 529-538. Date of Electronic Publication: 2023 Nov 10.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 9102703 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-3117 (Electronic) Linking ISSN: 10532498 NLM ISO Abbreviation: J Heart Lung Transplant Subsets: MEDLINE
أسماء مطبوعة: Publication: 1999- : New York, NY : Elsevier
Original Publication: St. Louis, Mo. : Mosby-Year Book, Inc., c1991-
مواضيع طبية MeSH: Heart-Assist Devices*/adverse effects , Prosthesis-Related Infections*/diagnostic imaging , Prosthesis-Related Infections*/etiology , Bacteremia*/diagnosis , Bacteremia*/etiology, Humans ; Fluorodeoxyglucose F18 ; Positron Emission Tomography Computed Tomography/methods ; Tomography, X-Ray Computed ; Retrospective Studies
مستخلص: Background: Previous retrospective studies suggest a good diagnostic performance of 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET)/computed tomography (CT) in left ventricular assist device (LVAD) infections. Our aim was to prospectively evaluate the role of PET/CT in the characterization and impact on clinical management of LVAD infections.
Methods: A total of 40 patients (aged 58 [53-62] years) with suspected LVAD infection and 5 controls (aged 69 [64-71] years) underwent 18 F-FDG-PET/CT. Four LVAD components were evaluated: exit site and subcutaneous driveline (peripheral), pump pocket, and outflow graft. The location with maximal uptake was considered the presumed site of infection. Infection was confirmed by positive culture (exit site or blood) and/or surgical findings.
Results: Visual uptake was present in 40 patients (100%) in the infection group vs 4 (80%) control subjects. For each individual component, the presence of uptake was more frequent in the infection than in the control group. The location of maximal uptake was most frequently the pump pocket (48%) in the infection group and the peripheral components (75%) in the control group. Maximum standard uptake values (SUV max ) were higher in the infection than in the control group: SUV max (average all components): 6.9 (5.1-8.5) vs 3.8 (3.7-4.3), p = 0.002; SUV max (location of maximal uptake): 10.6 ± 4.0 vs 5.4 ± 1.9, p = 0.01. Pump pocket infections were more frequent in patients with bacteremia than without bacteremia (79% vs 31%, p = 0.011). Pseudomonas (32%) and methicillin-susceptible Staphylococcus aureus (29%) were the most frequent pathogens and were associated with pump pocket infections, while Staphylococcus epidermis (11%) was associated with peripheral infections. PET/CT affected the clinical management of 83% of patients with infection, resulting in surgical debridement (8%), pump exchange (13%), and upgrade in the transplant listing status (10%), leading to 8% of urgent transplants.
Conclusions: 18 F-FDG-PET/CT enables the diagnosis and characterization of the extent of LVAD infections, which can significantly affect the clinical management of these patients.
(Copyright © 2023 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: HHSN268201000045C United States HL NHLBI NIH HHS; KL2 TR001435 United States TR NCATS NIH HHS; R01 HL135878 United States HL NHLBI NIH HHS; R01 HL166720 United States HL NHLBI NIH HHS
فهرسة مساهمة: Keywords: 18F-fluorodeoxyglucose positron emission tomography; LVAD infection; PET/CT; advanced heart failure; device infection
المشرفين على المادة: 0Z5B2CJX4D (Fluorodeoxyglucose F18)
تواريخ الأحداث: Date Created: 20231111 Date Completed: 20240318 Latest Revision: 20240330
رمز التحديث: 20240330
مُعرف محوري في PubMed: PMC10969750
DOI: 10.1016/j.healun.2023.11.002
PMID: 37951322
قاعدة البيانات: MEDLINE
الوصف
تدمد:1557-3117
DOI:10.1016/j.healun.2023.11.002