Peri-Coronary Adipose Tissue Density Is Associated With 18F-Sodium Fluoride Coronary Uptake in Stable Patients With High-Risk Plaques
Peri-Coronary Adipose Tissue Density Is Associated With 18F-Sodium Fluoride Coronary Uptake in Stable Patients With High-Risk Plaques
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DOI：
10.1016/j.jcmg.2018.11.032
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发表时间：
2019-10-01
影响因子：
14
通讯作者：
Berman, Daniel S.
中科院分区：
文献类型：
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作者：
Kwiecinski, Jacek;Dey, Damini;Berman, Daniel S.
本研究旨在评估冠状动脉计算机断层扫描血管造影（CTA）显示的高危冠状动脉斑块（HRPs）稳定患者的正电子发射断层扫描（PET）显示病变笔冠状动脉脂肪组织（PCAT）密度增加与冠状动脉F-18-氟化钠（F-18-NaF）摄取之间的相关性。PCAT密度增加与血管炎症相关。目前，在冠状动脉CTA显示有HRP的稳定患者中，PCAT密度增加与F-18-NaF摄取之间的关系尚未得到表征。方法：对接受冠状动脉CTA的患者进行HRP筛查，HRP由3个并发斑块特征定义：正性重塑;低衰减斑块（斑块体积>100 mm（3）= 50%）。招募具有HRP的患者进行F-18-NaF PET/CT。在狭窄>= 25%的病变中，定量斑块分析，平均PCAT密度，最大冠状动脉运动校正的F-18-NaF标准摄取值（SUVmax），和目标-背景比（TBR）进行了测量。23例患者（56%）的51处病变显示冠状动脉F-18-NaF活性增加。具有F-18-NaF摄取的病变具有比没有F-18-NaF摄取的病变更高的周围PCAT密度（-73HU;四分位数范围79至68 HU对比86 HU;四分位数范围94至80 HU; p < 0.001）。F-18-NaF TBR和SUVmax与PCAT密度相关（分别为r 0.63和r 0.68;均p < 0.001）。经校正的多元回归分析，病灶PCAT密度和病灶体积的增加与F-18-NaF TBR相关，（β = 0.25; 95%置信区间：0.17至0.34; PCAT的p < 0.001，以及（β = 0.07; 95%置信区间：0.03至0.11;结论：在冠状动脉CTA显示HRP特征的患者中，PCAT密度增加与局灶性F-18-NaF PET摄取相关。通过F-18-NaF PET和CTA同时评估这些成像生物标志物可能会改善具有HRP特征的稳定患者的心血管风险预测。(C)2019年由美国心脏病学会基金会。
OBJECTIVES This study aimed to assess the association between increased lesion pen-coronary adipose tissue (PCAT) density and coronary F-18-sodium fluoride (F-18-NaF) uptake on positron emission tomography (PET) in stable patients with high-risk coronary plaques (HRPs) shown on coronary computed tomography angiography (CTA).BACKGROUND Coronary F-18-NaF uptake reflects the rate of calcification of coronary atherosclerotic plaque. Increased PCAT density is associated with vascular inflammation. Currently, the relationship between increased PCAT density and F-18-NaF uptake in stable patients with HRPs on coronary CTA has not been characterized.METHODS Patients who underwent coronary CTA were screened for HRP, which was defined by 3 concurrent plaque features: positive remodeling; low attenuation plaque (LAP) (= 50% (plaque volume >100 mm(3)). Patients with HRPs were recruited to undergo F-18-NaF PET/CT. In lesions with stenosis >= 25%, quantitative plaque analysis, mean PCAT density, maximal coronary motion-corrected F-18-NaF standard uptake values (SUVmax), and target-to-background ratios (TBR) were measured.RESULTS Forty-one patients (age 65 +/- 16 years; 68% men) were recruited. Fifty-one lesions in 23 patients (56%) showed increased coronary F-18-NaF activity. Lesions with F-18-NaF uptake had higher surrounding PCAT density than those without F-18-NaF uptake (-73 HU; interquartile range 79 to 68 HU vs. 86 HU; interquartile range 94 to 80 HU; p < 0.001). F-18-NaF TBR and SUVmax were correlated with PCAT density (r 0.63 and r 0.68, respectively; all p < 0.001). On adjusted multiple regression analysis, increased lesion PCAT density and LAP volume were associated with F-18-NaF TBR (beta = 0.25; 95% confidence interval: 0.17 to 0.34; p < 0.001 for PCAT, and (beta = 0.07; 95% confidence interval: 0.03 to 0.11; p = 0.002 for LAP).CONCLUSIONS In patients with HRP features on coronary CTA, increased density of PCAT was associated with focal F-18-NaF PET uptake. Simultaneous assessment of these imaging biomarkers by F-18-NaF PET and CTA might refine cardiovascular risk prediction in stable patients with HRP features. (C) 2019 by the American College of Cardiology Foundation.