RT Journal Article SR Electronic T1 18-FDG uptake on PET-CT and metabolism in pulmonary arterial hypertension JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA588 DO 10.1183/13993003.congress-2021.PA588 VO 58 IS suppl 65 A1 Jeisson Osorio Trujillo A1 Olga Tura-Ceide A1 Javier Pavia A1 Ivan Vollmer A1 Isabel Blanco A1 Valerie Smolders A1 Aida Ninerola A1 Pilar Paredes A1 Jesús Ruiz-Cabello A1 Manel Castellà A1 Yolanda Torralba A1 Laura Sebastián A1 Lucilla Piccari A1 Víctor Peinado A1 Daniel Aguilar A1 Joan Albert Barberà YR 2021 UL http://erj.ersjournals.com/content/58/suppl_65/PA588.abstract AB Background: Proliferative changes in pulmonary hypertension can contribute to the development of idiopathic pulmonary arterial hypertension (iPAH). Energy needed to support cell proliferation may rely on aerobic glycolysis (Warburg effect). Image assessment of cell proliferation in PAH with FDG PET/CT (18F fluorodeoxyglucose positron emission tomography/computed tomography) have shown increased cellular metabolism in right ventricle (RV), while the results in pulmonary artery (PA) and pulmonary parenchyma (PP) are contradictory. In this study we evaluated the relationship between cellular metabolism in PA, RV and PP assessed with FDG PET/CT and the metabolic profile in plasma in patients with iPAH.Methods: We evaluated 12 patients with iPAH who underwent PET/CT scanning and 18F-FDG uptake (SUV) in predefined regions of interest were correlated with clinical and hemodynamic parameters, as well as with levels of plasma metabolites. as well as with levels of plasma metabolites assessed by quantitative targeted metabolomic studies using liquid chromatography (LC) coupled to mass spectrometry.Results: The RV SUV correlated with pro-BNP, 6MWD and cardiac index. Patients with iPAH had increased levels of isoleucine, 15-Hydroxyeicosatetraenoic acid (15-HETE), Glutamic acid and diacylglycerol 36:3 (DG 36:1) among other metabolites that were correlated with FDG uptake in FDG PET/CT (Table 1)Conclusions: In iPAH, the intensity of FDG uptake in pulmonary arteries, right ventricle, and lung parenchyma is associated with systemic parameters that reflect increased cell metabolism. Overall, our findings support the notion of increased cell proliferation in iPAH.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA588.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).