Prevalence and Risk Factors of Carotid Vessel Wall Inflammation in Coronary Artery Disease Patients FDG-PET and CT Imaging Study
Prevalence and Risk Factors of Carotid Vessel Wall Inflammation in Coronary Artery Disease Patients FDG-PET and CT Imaging Study
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DOI：
10.1016/j.jcmg.2011.07.008
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发表时间：
2011-11-01
影响因子：
14
通讯作者：
Fayad, Zahi A.
中科院分区：
文献类型：
--
作者：
Bucerius, Jan;Duivenvoorden, Raphael;Fayad, Zahi A.
目的 我们通过 F-18-氟脱氧葡萄糖正电子发射断层扫描 (FDG-PET) 在冠状动脉疾病 (CAD) 患者群体中调查颈动脉血管壁炎症的患病率和临床危险因素。 背景 动脉粥样硬化疾病过程的特点是氧化脂质在动脉壁中浸润和滞留，从而引发不成比例的炎症反应。人们已经努力使用非侵入性成像来量化血管壁中的这种炎症反应。最近，颈动脉 FDG-PET 已被证明可以反映葡萄糖的代谢率，这一过程已知在发炎组织中会增强。 方法 对 82 名 CAD 患者（年龄 62 +/- 10 岁）的颈动脉炎症进行量化，作为最大目标与背景比 (wholevesselTBRmax)。此外，我们还评估了通过 FDG-PET 测量的动脉壁中 FDG 摄取的最大标准化摄取值 (全血管SUVmax)、单个最热节段 (SHS) 和活性节段百分比 (PAS)。结果 67% 的人群存在全血管 TBRmax >1.8，39% 的人群存在 >2.0，23% 的人群存在 >2.2，12% 的人群存在 >2.4。向后消除的多元线性回归分析显示，体重指数 (BMI) >= 30 kg/m(2) (p < 0.0001)、年龄 > 65 岁 (p = 0.01)、吸烟 (p = 0.02) 和高血压 (p = 0.01) 与 WholevesselTBRmax 相关。代谢综合征的成分数量也与全血管 TBRmax 相关（p = 0.02）。在类似的分析中，wholevesselSUVmax 与 BMI >= 30 kg/m(2) (p < 0.0001)、年龄 >65 岁 (p = 0.004)、男性 (p = 0.02) 和高血压 (p = 0.04) 相关； BMI >= 30 kg/m(2) (p < 0.0001)、年龄 >65 岁 (p = 0.02)、吸烟 (p = 0.04) 和高血压 (p = 0.05) 的 SHS； BMI >= 30 kg/m(2) (p = 0.001)、吸烟 (p = 0.03) 和高血压 (p = 0.01) 的 PAS。 结论 FDG-PET 显示的颈动脉炎症在 CAD 人群中非常普遍，并且与肥胖、年龄超过 65 岁、高血压病史、吸烟和男性相关。当代谢综合征的成分聚集时，动脉壁 FDG 摄取增加。 (J Am Coll Cardiol Img 2011;4:1195-205) (C) 2011 年，美国心脏病学会基金会
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