Vascular Inflammation in Subclinical Atherosclerosis Detected by Hybrid PET/MRI

Fernández‐Friera, Leticia; Fuster, Valentín; López-Melgar, Beatriz; Oliva, Belén; Sánchez‐González, Javier; Macías, Ángel Ramos; Pérez-Asenjo, Braulio; Zamudio, Daniel; Farto, J.C. Alonso; España, Samuel; Mendiguren, José M.; Bueno, Héctor; García-Ruiz, José M.; Ibáñez, Borja; Fernández‐Ortíz, Antonio; Sanz, Javier

doi:10.1016/j.jacc.2018.12.075

Cited by 130 publications

(91 citation statements)

References 43 publications

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“…Additionally, arterial uptake of FDG is influenced by plaque composition. In line with our findings, the largest study to date evaluating the presence of vascular inflammation by 18 F-FDG-PET/MRI in individuals with atheromatosis, showed that most FDG uptakes were detected in plaque-free arterial segments (suggesting an arterial inflammatory state at early stages of atherosclerosis) and in lipid-rich plaques [27]. Interestingly, previous studies performed in subjects with atherosclerotic disease did not observe a relationship between markers of systemic inflammation and 18F-FDG PET/CT in patients with carotid stenosis [11].…”

Section: Discussionsupporting

confidence: 91%

Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study

Pérez‐Fernández

Irimia

Rodríguez

et al. 2020

BMC Cardiovasc Disord

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Background: Major adverse cardiovascular events are the main cause of morbidity and mortality over the long term in patients undergoing carotid endarterectomy. There are few reports assessing the prognostic value of markers of inflammation in relation to the risk of cardiovascular disease after carotid endarterectomy. Here, we aimed to determine whether matrix metalloproteinases (MMP-1, MMP-2, MMP-7, MMP-9 and MMP-10), tissue inhibitor of MMPs (TIMP-1) and in vivo inflammation studied by 18 F-FDG-PET/CT predict recurrent cardiovascular events in patients with carotid stenosis who underwent endarterectomy. Methods: This prospective cohort study was carried out on 31 consecutive patients with symptomatic (23/31) or asymptomatic (8/31) severe (> 70%) carotid stenosis who were scheduled for carotid endarterectomy between July 2013 and March 2016. In addition, 26 healthy controls were included in the study. Plasma and serum samples were collected 2 days prior to surgery and tested for MMP-1, MMP-2, MMP-7, MMP-9, MMP-10, TIMP-1, high-density lipoprotein, low-density lipoprotein, high-sensitivity C-reactive protein and erythrocyte sedimentation rate. 18 F-FDG-PET/CT focusing on several territories' vascular wall metabolism was performed on 29 of the patients because of no presurgical availability in 2 symptomatic patients. Histological and immunohistochemical studies were performed with antibodies targeting MMP-10, MMP-9, TIMP-1 and CD68. Results: The patients with carotid stenosis had significantly more circulating MMP-1, MMP-7 and MMP-10 than the healthy controls. Intraplaque TIMP-1 was correlated with its plasma level (r = 0.42 P = .02) and with 18 F-FDG uptake (r = 0.38 P = .05). We did not find any correlation between circulating MMPs and in vivo carotid plaque metabolism assessed by 18 F-FDG-PET. After a median follow-up of 1077 days, 4 cerebrovascular, 7 cardiovascular and 11 peripheral vascular events requiring hospitalization were registered. Circulating MMP-7 was capable of predicting events over and above the traditional risk factors (HR = 1.15 P = .006). When the model was associated with the variables of interest, the risk predicted by 18 F-FDG-PET was not significant. Conclusions: Circulating MMP-7 may represent a novel marker for recurrent cardiovascular events in patients with moderate to severe carotid stenosis. MMP-7 may reflect the atherosclerotic burden but not plaque inflammation in this specific vascular territory.

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Section: Discussionsupporting

confidence: 91%

Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study

Pérez‐Fernández

Irimia

Rodríguez

et al. 2020

BMC Cardiovasc Disord

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“…Differences of IMT in inflammatory diseases, i.e., Takayasu arteritis and giant cell arteritis, may vary several millimeters over time and due to medication. Vessel wall changes in inflammatory disease can be evaluated by different imaging modalities, such as computerized tomography scan, arterial angiography, magnetic resonance imaging (MRI), positron emission tomography (PET), and combined PET-MRI ( 47 ). Compared to US, however, these methods have lower resolution, are more expensive, and expose the patient for radiation and have an overall lower availability.…”

Section: Discussionmentioning

confidence: 99%

High-Frequency Ultrasound of Multiple Arterial Areas Reveals Increased Intima Media Thickness, Vessel Wall Appearance, and Atherosclerotic Plaques in Systemic Lupus Erythematosus

et al. 2020

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Introduction: Despite improved therapies and management, patients with systemic lupus erythematosus (SLE) still have increased risks of cerebrovascular and cardiovascular disease. High-frequency ultrasound (US) provides an opportunity to distinguish atherosclerosis from inflammation in the vessels. We hypothesized that an extended US protocol may add information regarding vascular affection in SLE. Methods: Sixty patients (52 women, 8 men; mean age 43.2 ± 11.3 years) with SLE characterized by either lupus nephritis (LN; n = 20), antiphospholipid syndrome (APS; n = 20), or skin and joint involvement ( n = 20) as well as matched healthy controls ( n = 60) were included. Intima-media thickness (IMT), assessment of vessel walls, and plaque occurrence were recorded using high-frequency US (GE Logic E9) in common carotid, internal carotid, brachiocephalic, subclavian, axillary, common femoral, and proximal superficial femoral arteries as well as in the aortic arch. Results: For the entire SLE group, IMT was increased in the internal carotid artery (0.52 ± 0.17 vs. 0.45 ± 0.09 mm, p = 0.004), the common femoral artery (0.57 ± 0.23 vs. 0.49 ± 0.11 mm, p < 0.01), the subclavian artery (0.58 ± 0.19 vs. 0.53 ± 0.13 mm, p = 0.02), and the aortic arch (1.21 ± 0.63 vs. 0.98 ± 0.25 mm, p = 0.002) compared to controls. These differences were primarily observed in the APS and LN groups compared to controls. Vessels with increased IMT ≥0.9 mm had a smooth, medium echogenic appearance in areas free of atherosclerotic plaques. Atherosclerotic plaques were detected in 15/60 patients (25%) as compared to 2/60 of the controls (3%). Plaques were predominantly (67%) located in the carotid bifurcation. Multivariate analysis revealed influence of age on IMT in all vessel areas. Furthermore, in the common femoral artery, sagittal abdominal diameter, diastolic blood pressure, and cholesterol all showed association with increased IMT. In the internal carotid artery, male sex and presence of Raynaud phenomenon influenced IMT. Conclusion: Among SLE patients without presence of plaques, an extended US protocol revealed increased wall thickness with predominantly medium echogenic appearance highlighting possibly inflammation or early atherosclerosis. The appearance of vessel walls has not previously been studied in detail. An increased number of plaques were found in SLE compared to age- and sex-matched healthy controls. We found similar risk factors for increased IMT and occurrence of plaques, possibly indicating atherosclerotic mechanisms rather than inflammation.

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“…Известно, что у пациентов с различными хроническими системными воспалительными заболеваниями отмечается увеличение ТКИМ сонных артерий [28,29]. В исследовании PESA (Progression of Early Subclinical Atherosclerosis) оценивали воспаление в сосудистой стенке различных артериальных бассейнов методом гибридной визуализации (магнитно-резонансная томография, совмещенная с позитронно-эмиссионной томографией с 18 F-фтордезоксиглюкозой) [30]. Было установлено, что воспаление в стенке бедренных артерий встречается существенно чаще, чем в сонных -24,4% против 15,8%.…”

Section: Discussionunclassified

Intima-media thickness of the common femoral arteries as a marker for coronary atherosclerosis in patients with coronary artery disease

Генкель¹,

Кузнецова²,

Kolyadich³

et al. 2020

CPT

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Vascular Inflammation in Subclinical Atherosclerosis Detected by Hybrid PET/MRI

Cited by 130 publications

References 43 publications

Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study

Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study

High-Frequency Ultrasound of Multiple Arterial Areas Reveals Increased Intima Media Thickness, Vessel Wall Appearance, and Atherosclerotic Plaques in Systemic Lupus Erythematosus

Intima-media thickness of the common femoral arteries as a marker for coronary atherosclerosis in patients with coronary artery disease

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