Association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors, plaque burden and pericardial fat volume: a PET/CT study

Saam, Tobias; Rominger, Axel; Wolpers, Sarah; Nikolaou, Konstantin; Rist, Carsten; Martin, Guillaume; Cumming, Paul; Becker, Alexander; Foerster, Stefan; Reiser, Maximilian; Bartenstein, Peter; Hacker, Marcus

doi:10.1007/s00259-010-1432-2

Cited by 62 publications

(37 citation statements)

References 26 publications

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“…On the other hand, fatty acids are involved in intralesional lipid homeostasis and macrophage inflammatory responses through action of peroxisome proliferator-activated receptors and liver X receptors (3). Therefore, 11 C-acetate depicts molecular processes in a manner different from 18 F-FDG or choline compounds, which may be used to provide information about macrophage-mediated inflammation or cell membrane proliferation in atherosclerotic lesions (34,35). The increasing number of tracers available for the characterization of pathophysiologic processes in atherosclerotic plaque-and their complementary use-may eventually lead to a more thorough understanding of the complex interactions in the development and evolution of plaque.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of ¹¹C-Acetate PET/CT for Imaging of Fatty Acid Synthesis in the Atherosclerotic Vessel Wall

Derlin¹,

Habermann²,

Lengyel³

et al. 2011

J Nucl Med

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Fatty acids are a common constituent of atherosclerotic plaque and may be synthesized in the plaque itself. Fatty acid synthesis requires acetyl-coenzyme-A (CoA) as a main substrate, which is produced from acetate. Currently, 11 C-acetate PET/CT is used for the evaluation of malignancies. There are no data concerning its potential for the characterization of atherosclerotic plaque. Therefore, the purpose of the present study was to examine the prevalence, distribution, and topographic relationship of arterial 11 C-acetate uptake and vascular calcification in major arteries. Methods: Thirty-six patients were examined by wholebody 11 C-acetate PET/CT. Tracer uptake in various arterial segments was analyzed both qualitatively and semiquantitatively by measuring the blood-pool-corrected standardized uptake value (target-to-background ratio). CT images were used to measure calcified plaque burden. Results: 11 C-acetate uptake was observed at 220 sites in 32 (88.8%) of the 36 study patients, and mean target-to-background ratio was 2.5 6 1.0. Calcified atherosclerotic lesions were observed at 483 sites in 30 (83.3%) patients. Sixty-four (29.1%) of the 220 lesions with marked 11 Cacetate uptake were colocalized with arterial calcification. However, only 13.3% of all arterial calcification sites demonstrated increased radiotracer accumulation. Conclusion: Our data indicate the feasibility of using 11 C-acetate PET/CT for imaging of fatty acid synthesis in the atherosclerotic vessel wall. This study provides a rationale to incorporating 11 C-acetate PET into further preclinical and clinical studies to obtain new insights into fatty acid synthesis in atherosclerotic lesions and to evaluate whether it may be used to monitor pharmacologic intervention with fatty acid synthase inhibitors.

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Section: Discussionmentioning

confidence: 99%

Feasibility of ¹¹C-Acetate PET/CT for Imaging of Fatty Acid Synthesis in the Atherosclerotic Vessel Wall

Derlin¹,

Habermann²,

Lengyel³

et al. 2011

J Nucl Med

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“…There is an emerging role for nuclear medicine techniques such as PET/CT in assessing atherosclerosis by analyzing the biologic composition and pathophysiologic processes in atherosclerotic lesions (9,13,16,22). Common PET tracers currently in use or under investigation for assessment of atherosclerosis exhibit some inherent limitations.…”

Section: Comparison To Other Pet Tracers and Cardiovascular Risk Factorsmentioning

confidence: 99%

“…18 F-FDG uptake in atherosclerotic lesions correlates with the presence of cardiovascular risk factors and might identify patients at risk for future vascular events (9,(12)(13)(14). Recently, several authors reported visualization of macrophage activity in atherosclerotic plaque using 18 Ffluorocholine and 11 C-choline PET/CT (15)(16)(17).…”

mentioning

confidence: 99%

In Vivo Imaging of Mineral Deposition in Carotid Plaque Using ¹⁸F-Sodium Fluoride PET/CT: Correlation with Atherogenic Risk Factors

Derlin¹,

Wisotzki²,

Richter³

et al. 2011

J Nucl Med

150

111

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The purpose of this study was to correlate 18 F-sodium fluoride accumulation in the common carotid arteries of neurologically asymptomatic patients with cardiovascular risk factors and carotid calcified plaque burden. Methods: Two hundred sixtynine oncologic patients were examined by 18 F-sodium fluoride PET/CT. Tracer accumulation in the common carotid arteries was analyzed both qualitatively and semiquantitatively by measuring the blood-pool-corrected standardized uptake value (target-to-background ratio) and comparing it with cardiovascular risk factors and calcified plaque burden. Results: 18 Fsodium fluoride uptake was observed at 141 sites in 94 (34.9%) patients. Radiotracer accumulation was colocalized with calcification in all atherosclerotic lesions. 18 F-sodium fluoride uptake was significantly associated with age (P , 0.0001), male sex (P , 0.0001), hypertension (P , 0.002), and hypercholesterolemia (P , 0.05). The presence of calcified plaque correlated significantly with these risk factors but also with diabetes (P , 0.0001), history of smoking (P 5 0.03), and prior cardiovascular events (P , 0.01). There was a highly significant correlation between the presence of 18 F-sodium fluoride uptake and number of present cardiovascular risk factors (r 5 0.30, P , 0.0001). Conclusion: Carotid 18 F-sodium fluoride uptake is a surrogate measure of calcifying carotid plaque, correlates with cardiovascular risk factors, and is more frequent in patients with a high-risk profile for atherothrombotic events but demonstrates a weaker correlation with risk factors than does calcified plaque burden. This study provides a rationale to conduct further prospective studies to determine whether 18 F-sodium fluoride uptake can predict vascular events, or if it may be used to monitor pharmacologic therapy.

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“…They demonstrated higher FDG uptake in the stented segments in acute coronary syndrome, as well as in the relatively fixed left main coronary artery and the ascending aorta, consistent with a multifocal inflammatory response in unstable atherosclerosis. Published in 2010, Saam [80] measured FDG uptake in the coronary arteries of close to 300 subjects with cancer. Evaluation of coronary artery FDG uptake was only possible in half of those imaged; the remainder had myocardial FDG uptake that swamped any signal from the coronary plaque.…”

Section: Imaging the Coronary Arteriesmentioning

confidence: 99%

Vascular imaging with positron emission tomography

Joshi

Rosenbaum

Bordes

et al. 2011

Journal of Internal Medicine

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Atherosclerosis is an inflammatory disease that causes most myocardial infarctions, strokes and acute coronary syndromes. Despite the identification of multiple risk factors and widespread use of drug therapies, it still remains a global health concern with associated costs. Although angiography is established as the gold standard means of detecting coronary artery stenosis, it does not image the vessel wall itself, reporting only on its consequences such as luminal narrowing and obstruction. MRI and computed tomography provide more information about the plaque structure, but recently positron emission tomography (PET) imaging using [ 18 F]-fluorodeoxyglucose (FDG) has been advocated as a means of measuring arterial inflammation. This results from the ability of FDG-PET to highlight areas of high glucose metabolism, a feature of macrophages within atherosclerosis, particularly in high-risk plaques. It is suggested that the degree of FDG accumulation in the vessel wall reflects underlying inflammation levels and that tracking any changes in FDG uptake over time or with drug therapy might be a way of getting an early efficacy readout for novel anti-atherosclerotic drugs. Early reports also demonstrate that FDG uptake is correlated with the number of cardiovascular risk factors and possibly even the risk of future cardiovascular events. This review will outline the evidence base, shortcomings and emerging applications for FDG-PET in vascular imaging. Alternative PET tracers and other candidate imaging modalities for measuring vascular inflammation will also be discussed.

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Association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors, plaque burden and pericardial fat volume: a PET/CT study

Abstract: FDG uptake measurement in the LAD correlates with hypertension, coronary heart disease, BMI, PFV and CPB. However, due to myocardial FDG uptake these measurements are only feasible in one half of the patients.

Cited by 62 publications

References 26 publications

Feasibility of ¹¹C-Acetate PET/CT for Imaging of Fatty Acid Synthesis in the Atherosclerotic Vessel Wall

Feasibility of ¹¹C-Acetate PET/CT for Imaging of Fatty Acid Synthesis in the Atherosclerotic Vessel Wall

In Vivo Imaging of Mineral Deposition in Carotid Plaque Using ¹⁸F-Sodium Fluoride PET/CT: Correlation with Atherogenic Risk Factors

Vascular imaging with positron emission tomography

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Association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors, plaque burden and pericardial fat volume: a PET/CT study

Abstract: FDG uptake measurement in the LAD correlates with hypertension, coronary heart disease, BMI, PFV and CPB. However, due to myocardial FDG uptake these measurements are only feasible in one half of the patients.

Cited by 62 publications

References 26 publications

Feasibility of 11C-Acetate PET/CT for Imaging of Fatty Acid Synthesis in the Atherosclerotic Vessel Wall

Feasibility of 11C-Acetate PET/CT for Imaging of Fatty Acid Synthesis in the Atherosclerotic Vessel Wall

In Vivo Imaging of Mineral Deposition in Carotid Plaque Using 18F-Sodium Fluoride PET/CT: Correlation with Atherogenic Risk Factors

Vascular imaging with positron emission tomography

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Feasibility of ¹¹C-Acetate PET/CT for Imaging of Fatty Acid Synthesis in the Atherosclerotic Vessel Wall

Feasibility of ¹¹C-Acetate PET/CT for Imaging of Fatty Acid Synthesis in the Atherosclerotic Vessel Wall

In Vivo Imaging of Mineral Deposition in Carotid Plaque Using ¹⁸F-Sodium Fluoride PET/CT: Correlation with Atherogenic Risk Factors