Chagas心脏病（CHD）是以进行性心肌炎症以及心肌纤维化和片段性异常为特征的疾病，可能导致恶性室性心律失常和猝死。这种心律失常可能与晚期CHD中心肌内寄生虫持续感染或炎症有关。正电子发射计算机断层显像/计算机断层扫描（PET/CT）已被用于检测非缺血型心肌病，如结节病炎中的心肌炎症，并可能对CHD患者的风险预测有用。 本前瞻性横断面研究于2019年5月至2022年3月期间招募了24名慢性CHD门诊患者。患者分为两组：那些需植入心脏除颤器的持续性室性心动过速和/或突然心脏死亡的患者，以及那些具有相同CHD分期但无复杂性室性心律失常的患者。患者接受了18F-脱氧葡萄糖（18F-FDG）和68Ga-DOTATOC PET/CT检查，并采集了血样进行聚合酶链反应定性检测寄生虫。尽管患有和不患有复杂性室性心律失常的患者所示的18F-FDG和68Ga-DOTATOC摄取比例相似，但68Ga-DOTATOC修正的SUVmax在复杂心律失常的患者中较高（3.4比1.7；P = .046），暗示炎症可能与CHD晚期的恶性心律失常存在关联。我们还在两组患者中检测到Trypanosoma cruzi，而在具有恶性心律失常组中有增加的寄生虫感染趋势，但没有统计学显著性（66.7%对33.3%）。 PET/CT上的18F-FDG和68Ga-DOTATOC摄取可能对检测Chagas心肌病患者的心肌炎症有用，并且68Ga-DOTATOC摄取可能与恶性心律失常的存在有关，具有潜在的治疗意义。 © 2023。作者独家授权给美国核医学学会。

Chagas heart disease (CHD) is characterized by progressive myocardial inflammation associated with myocardial fibrosis and segmental abnormalities that may lead to malignant ventricular arrhythmia and sudden cardiac death. This arrhythmia might be related to the persistence of parasitemia or inflammation in the myocardium in late-stage CHD. Positron emission tomography/computed tomography (PET/CT) has been used to detect myocardial inflammation in non-ischemic cardiomyopathies, such as sarcoidosis, and might be useful for risk prediction in patients with CHD.Twenty-four outpatients with chronic CHD were enrolled in this prospective cross-sectional study between May 2019 and March 2022. The patients were divided into two groups: those with sustained ventricular tachycardia and/or aborted sudden cardiac death who required implantable cardioverter-defibrillators, and those with the same stages of CHD and no complex ventricular arrhythmia. Patients underwent 18F-fluorodeoxyglucose (18F-FDG) and 68Ga-DOTATOC PET/CT, and blood samples were collected for qualitative parasite assessment by polymerase chain reaction. Although similar proportions of patients with and without complex ventricular arrhythmia showed 18F-FDG and 68Ga-DOTATOC uptake, 68Ga-DOTATOC corrected SUVmax was higher in patients with complex arrhythmia (3.4 vs 1.7; P = .046), suggesting that inflammation could be associated with the presence of malignant arrhythmia in the late stages of CHD. We also detected Trypanosoma cruzi in both groups, with a nonsignificant trend of increased parasitemia in the group with malignant arrhythmia (66.7% vs 33.3%).18F-FDG and 68Ga-DOTATOC uptake on PET/CT may be useful for the detection of myocardial inflammation in patients with Chagas cardiomyopathy, and 68Ga-DOTATOC uptake may be associated with the presence of malignant arrhythmia, with potential therapeutic implications.© 2023. The Author(s) under exclusive licence to American Society of Nuclear Cardiology.