Feasibility of FDG Imaging of the Coronary Arteries Comparison Between Acute Coronary Syndrome and Stable Angina
Feasibility of FDG Imaging of the Coronary Arteries Comparison Between Acute Coronary Syndrome and Stable Angina
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DOI：
10.1016/j.jcmg.2010.01.004
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发表时间：
2010-04-01
影响因子：
14
通讯作者：
Tawakol, Ahmed
中科院分区：
文献类型：
--
作者：
Rogers, Ian S.;Nasir, Khurram;Tawakol, Ahmed
目的 本研究检验了这样的假设：使用正电子发射断层扫描 (PET) 测量的升主动脉和左冠状动脉主干 (LM) 内的氟脱氧葡萄糖 (FDG) 摄取，近期急性冠状动脉综合征 (ACS) 患者比稳定型心绞痛患者更高。 背景 众所周知，炎症在动脉粥样硬化中发挥着重要作用。 F-18-FDG 正电子发射断层扫描成像可测量斑块炎症。 方法 25 名患者（平均年龄 57.9 +/- 9.8 岁，72% 男性，10 例 ACS，15 例稳定型心绞痛）在侵入性血管造影后接受心脏计算机断层扫描血管造影和 F-18-FDG PET 成像。图像被配准，并在感兴趣的位置测量 FDG 摄取，以计算目标与背景比 (TBR)。此外，通过定位用于治疗该综合征的支架，在临床上被认为是导致该综合征（罪魁祸首）的病变部位测量 FDG 摄取量。 结果 ACS 组中升主动脉的 FDG 摄取量高于稳定型心绞痛组（中位[四分位距] TBR 3.30 [2.69 至 4.12] vs. 2.43 [2.00 至2.86]，p = 0.02），以及 LM（分别为 2.48 [2.30 至 2.93] 与 2.00 [1.71 至 2.44]，p = 0.03）。与 ACS 相关的罪魁祸首病变的 TBR 高于因稳定冠状动脉综合征而置入支架的病变（2.61 vs. 1.74，p = 0.02）。此外，支架病变（ACS 和稳定型心绞痛组）中的 TBR 与 C 反应蛋白相关（r = 0.58，p = 0.04）。 结论 这项研究表明，在近期患有 ACS 的患者中，肇事病变内以及升主动脉和 LM 内的 FDG 积累均增加。这一观察结果表明急性冠状动脉综合征中动脉粥样硬化斑块内存在炎症活动，并支持加强努力改进冠状动脉斑块分子成像的 PET 方法。 (J Am Coll Cardiol Img 2010;3:388-97) (C) 2010 年，美国心脏病学会基金会
OBJECTIVES This study tested the hypothesis that fluorodeoxyglucose (FDG) uptake within the ascending aorta and left main coronary artery (LM), measured using positron emission tomography (PET), is greater in patients with recent acute coronary syndrome (ACS) than in patients with stable angina.BACKGROUND Inflammation is known to play an important role in atherosclerosis. Positron emission tomography imaging with F-18-FDG provides a measure of plaque inflammation.METHODS Twenty-five patients (mean age 57.9 +/- 9.8 years, 72% male, 10 ACS, and 15 stable angina) underwent cardiac computed tomographic angiography and PET imaging with F-18-FDG after invasive angiography. Images were coregistered, and FDG uptake was measured at locations of interest for calculation of target-to-background ratios (TBR). Additionally, FDG uptake was measured at the site of the lesion deemed clinically responsible for the presenting syndrome (culprit) by virtue of locating the stent deployed to treat the syndrome.RESULTS The FDG uptake was higher in the ACS versus the stable angina groups in the ascending aorta (median [interquartile ranges] TBR 3.30 [2.69 to 4.12] vs. 2.43 [2.00 to 2.86], p = 0.02), as well as the LM (2.48 [2.30 to 2.93] vs. 2.00 [1.71 to 2.44], p = 0.03, respectively). The TBR was greater for culprit lesions associated with ACS than for lesions stented for stable coronary syndromes (2.61 vs. 1.74, p = 0.02). Furthermore, the TBR in the stented lesions (in ACS and stable angina groups) correlated with C-reactive protein (r = 0.58, p = 0.04).CONCLUSIONS This study shows that in patients with recent ACS, FDG accumulation is increased both within the culprit lesion as well as in the ascending aorta and LM. This observation suggests inflammatory activity within atherosclerotic plaques in acute coronary syndromes and supports intensification of efforts to refine PET methods for molecular imaging of coronary plaques. (J Am Coll Cardiol Img 2010;3:388-97) (C) 2010 by the American College of Cardiology Foundation