Prevalence and Risk Factors of Carotid Vessel Wall Inflammation in Coronary Artery Disease Patients FDG-PET and CT Imaging Study

JACC-CARDIOVASCULAR IMAGING

卷:4

Article

Bucerius, Jan^1,2,3  Duivenvoorden, Raphael^1,2,4  Mani, Venkatesh^1,2,5,6  Moncrieff, Colin^1,2  Rudd, James H. F.⁷  Calcagno, Claudia^1,2  Machac, Josef⁸  Fuster, Valentin^5,6,9  Farkouh, Michael E.¹⁰  Fayad, Zahi A.^1,2,5,6 

[1] Mt Sinai Sch Med, Translat & Mol Imaging Inst, New York, NY 10029 USA

[2] Mt Sinai Sch Med, Dept Radiol, New York, NY 10029 USA

[3] Univ Bonn, Dept Nucl Med, D-5300 Bonn, Germany

[4] Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1105 AZ Amsterdam, Netherlands

[5] Mt Sinai Sch Med, Dept Cardiol, Zena & Michael A Weiner Cardiovasc Inst, New York, NY 10029 USA

[6] Mt Sinai Sch Med, Marie Josee & Henry R Kravis Cardiovasc Hlth, New York, NY 10029 USA

[7] Univ Cambridge, Div Cardiovasc Med, Cambridge, England

[8] Mt Sinai Sch Med, Div Nucl Med, Dept Radiol, New York, NY 10029 USA

[9] CNIC, Madrid, Spain

[10] Mt Sinai Sch Med, Cardiovasc Imaging Clin Trials Unit, New York, NY 10029 USA

关键词: atherosclerosis;    FDG-PET;    inflammation;    metabolic syndrome;    obesity;   

DOI  :  10.1016/j.jcmg.2011.07.008

来源: Elsevier

【 摘 要 】

OBJECTIVES We investigated the prevalence and clinical risk factors of carotid vessel wall inflammation by means of F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in a population consisting of coronary artery disease (CAD) patients. BACKGROUND The atherosclerotic disease process is characterized by infiltration and retention of oxidized lipids in the artery wall, triggering a disproportionate inflammatory response. Efforts have been made to use noninvasive imaging to quantify this inflammatory response in the vessel wall. Recently, carotid FDG-PET has been shown to reflect the metabolic rate of glucose, a process known to be enhanced in inflamed tissue. METHODS Carotid inflammation was quantified in 82 CAD patients (age 62 +/- 10 years) as the maximum target-to-background ratio (wholevesselTBRmax). Furthermore, we assessed the maximal standardized uptake value values (wholevesselSUVmax), the single hottest segment (SHS), and the percent active segments (PAS) of the FDG uptake in the artery wall, measured by FDG-PET. RESULTS Whole-vessel TBRmax >1.8 was present in 67%, >2.0 in 39%, >2.2 in 23%, and >2.4 in 12% of the population. Multiple linear regression analysis with backward elimination revealed that body mass index (BMI) >= 30 kg/m(2) (p < 0.0001), age >65 years (p = 0.01), smoking (p = 0.02), and hypertension (p = 0.01) were associated with wholevesselTBRmax. The number of components of the metabolic syndrome was also associated with wholevesselTBRmax (p = 0.02). In similar analyses, wholevesselSUVmax was associated with BMI >= 30 kg/m(2) (p < 0.0001), age >65 years (p = 0.004), male gender (p = 0.02), and hypertension (p = 0.04); SHS with BMI >= 30 kg/m(2) (p < 0.0001), age >65 years (p = 0.02), smoking (p = 0.04), and hypertension (p = 0.05); PAS with BMI >= 30 kg/m(2) (p = 0.001), smoking (p = 0.03), and hypertension (p = 0.01). CONCLUSIONS Carotid inflammation as revealed by FDG-PET is highly prevalent in the CAD population and is associated with obesity, age over 65 years, history of hypertension, smoking, and male gender. Artery wall FDG uptake increased when components of the metabolic syndrome clustered. (J Am Coll Cardiol Img 2011;4:1195-205) (C) 2011 by the American College of Cardiology Foundation

【 授权许可】

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