尽管心房炎症在房颤（AF）的病理生理中起到重要作用，但是心房炎症的鉴定仍然具有挑战性。我们的目的是建立一种正电子发射计算机体层摄影/计算机断层扫描（PET/CT）协议，使用18氟标记的脱氧葡萄糖（18F-FDG）来检测作为心房炎症代理的心房高代谢情况。我们纳入了n = 75例心房颤动患者和n = 75例非房颤患者进行三种常见的PET/CT协议（每组n = 25），这些协议针对（a）预定的禁食方案中的炎症，（b）预定的禁食方案中的恶性肿瘤，以及（c）允许最大化葡萄糖摄取的心脏生存能力进行了优化。我们在预定的位置分析了18F-FDG摄取。在禁食方案（炎症[13/25 vs 0/25]和恶性肿瘤[10/25 vs 0/25]）中观察到房颤与非房颤患者间的心房摄取差异，而生存能力方案显示两组均存在非特异性摄取。在炎症方案中，房颤患者右心房的摄取更高（最大标准摄取值：2.5±.7 vs 2.0±.7，P = .01），心房附壁摄取更高（最大标准摄取值：2.4±.7 vs 2.0±.6，P = .03），心外脂肪组织摄取更高（最大标准摄取值：1.4±.5 vs 1.1±.4，P = .04）。恶性肿瘤和生存能力方案无法区分房颤和非房颤。葡萄糖摄取抑制方案似乎适用于检测房颤和非房颤患者之间的不同心房18F-FDG摄取。基于影像的炎症评估可能有助于分层房颤患者，并提供个体化的治疗策略。 © 2023. 该作者持有美国核心心脏学会的独家许可。

Although atrial inflammation has been implicated in the pathophysiology of atrial fibrillation (AF), the identification of atrial inflammation remains challenging. We aimed to establish a positron emission tomography/computed tomography (PET/CT) protocol with 18Fluor-labeled fluorodeoxyglucose (18F-FDG) for the detection of atrial hypermetabolism as surrogate for inflammation in AF.We included n = 75 AF and n = 75 non-AF patients undergoing three common PET/CT protocols (n = 25 per group) optimized for the detection of (a) inflammation and (b) malignancy in predefined fasting protocols, and (c) cardiac viability allowing for maximized glucose uptake. 18F-FDG-uptake was analyzed in predefined loci.Differences of visual atrial uptake in AF vs non-AF patients were observed in fasting (inflammation [13/25 vs 0/25] and malignancy [10/25 vs 0/25]) protocols while viability protocols showed non-specific uptake in both the groups. In the inflammation protocol, AF patients showed higher uptake in the right atrium [(SUVmax: 2.5 ± .7 vs 2.0 ± .7, P = .01), atrial appendage (SUVmax: 2.4 ± .7 vs 2.0 ± .6, P = .03), and epicardial adipose tissue (SUVmax: 1.4 ± .5 vs 1.1 ± .4, P = .04)]. Malignancy and viability protocols failed to differentiate between AF and non-AF.Glucose uptake suppression protocols appear suitable in detecting differential atrial 18F-FDG uptake between AF and non-AF patients. Imaging-based assessment of inflammation might help to stratify AF patients offering individualized therapeutic approaches.© 2023. The Author(s) under exclusive licence to American Society of Nuclear Cardiology.