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Relevance of the low\u2010risk status assessment using available diagnostic tools requires a reliable confirmation. The study aimed to evaluate right ventricular perfusion and glucose metabolism using positron emission tomography (PET)\/computed tomography (CT) with [13N]\u2010ammonia and [18F]\u2010fluorodeoxyglucose ([18F]\u2010FDG) in 30 IPAH patients (33.8\u2009\u00b1\u20099.4 years) according to ESC\/ERS 2022 risk status. The ratio of SUVmax<jats:sub>RV\/LV<\/jats:sub> metabolism and SUVmax<jats:sub>RV\/LV<\/jats:sub> perfusion showed significant positive correlation with pulmonary artery pressure, right heart dilatation, NT\u2010proBNP level and negative correlation with the RV ejection fraction. The SUVmax<jats:sub>RV\/LV<\/jats:sub> perfusion and SUVmax<jats:sub>RV\/LV<\/jats:sub> metabolism ratios differed significantly according to risk status. Low risk patients had a SUVmax<jats:sub>RV\/LV<\/jats:sub> metabolism comparable to the controls without PH. The SUVmax<jats:sub>RV\/LV<\/jats:sub> perfusion ratio was elevated in low\u2010risk IPAH patients compared with controls. Increased SUVmax<jats:sub>RV\/LV<\/jats:sub> perfusion may be an early marker of coronary flow adaptation to RV pressure overload in low\u2010risk IPAH patients and requires further evaluation. Further long\u2010term studies are needed to determine the clinical relevance and cut\u2010off values for the RV\/LV PET\/CT with [13N]\u2010ammonia and [18F]\u2010fluorodeoxyglucose ([18F]\u2010FDG) uptake in different IPAH risk groups.<\/jats:p>","DOI":"10.1002\/pul2.70042","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T11:29:31Z","timestamp":1737545371000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["PET\/CT Imaging of the Right Heart Perfusion and Glucose Metabolism Depending on a Risk Status in Patients With Idiopathic Pulmonary Arterial Hypertension"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6954-7096","authenticated-orcid":false,"given":"Natalia","family":"Goncharova","sequence":"first","affiliation":[{"name":"Department of Noncoronary Disease Almazov National Medical Research Center Saint Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7086-9153","authenticated-orcid":false,"given":"Daria","family":"Ryzhkova","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Radiology Almazov National Medical Research Center Saint Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7337-0972","authenticated-orcid":false,"given":"Kirill","family":"Lapshin","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Department Almazov National Medical Research Center Saint Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-1104","authenticated-orcid":false,"given":"Anton","family":"Ryzhkov","sequence":"additional","affiliation":[{"name":"Department of Magnetic Resonance Imaging Almazov National Medical Research Center Saint Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5650-3558","authenticated-orcid":false,"given":"Aryana","family":"Malanova","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Radiology Almazov National Medical Research Center Saint Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6081-1559","authenticated-orcid":false,"given":"Elizaveta","family":"Andreeva","sequence":"additional","affiliation":[{"name":"Department of Noncoronary Disease Almazov National Medical Research Center Saint Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7817-3847","authenticated-orcid":false,"given":"Olga","family":"Moiseeva","sequence":"additional","affiliation":[{"name":"Department of Noncoronary Disease Almazov National Medical Research Center Saint Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00006511"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.09.040"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.063821"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1253\/circrep.CR-20-0006"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045894020935291"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.02.004"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2332\/allergolint.11-RAI-0362"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv317"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e3182177389"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000000422"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jet276"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/sum019"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-15-1185-1_24"},{"issue":"6","key":"e_1_2_12_16_1","first-page":"882","article-title":"Primary Myocardial Disease in Scleroderma\u2010A Comprehensive Review of the Literature to Inform the UK Systemic Sclerosis Study Group Cardiac Working Group","volume":"56","author":"Bissell L. 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