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Aortic valve microcalcification and cardiovascular risk: an exploratory study using sodium fluoride in high cardiovascular risk patients

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Abstract

18F-sodium fluoride (18F-NaF) has been used to access aortic stenosis in clinical research setting. It is known that its uptake is related with microcalcification. The purpose of this study was to assess the relationship between 18F-NaF uptake by the aortic valve and cardiovascular risk. Twenty-five patients with risk factors for cardiovascular disease, without known cardiovascular disease or aortic stenosis underwent PET-CT with 18F-NaF. Cardiovascular risk was assessed through the ASCVD (Atherosclerotic Cardiovascular Disease) risk calculator. Aortic valve 18F-NaF (AoVCUL) uptake was evaluated through the corrected uptake per lesion (CUL = max SUV − mean blood-pool SUV). Calcium score was obtained through cardiac CT. The patients present a mean age of 63.90 ± 8.60 years and 56% males. The mean ASCVD was of 28.76 ± 18.96 (M 25, IQR 38.50). The mean aortic valve calcium score (AoVCaSc) was of 53.24 ± 164.38 (M 6; IQR 29.75) and the AoVCUL was of 0.50 ± 0.10 (M 0.52, IQR 0.15). The patients were classified according to the ASCVD: patients with a risk greater or equal than the 50th percentile of the ASCVD risk and patients with a risk lower than the 50th percentile. The AoVCUL was evaluated in both groups: AoVCUL = 0.56 ± 0.10 vs 0.42 ± 0.15, p = 0.02; AoVCaSc was of 0 in 11 patients (44%) and those with an ASCVD greater or equal than the 50th percentile had a mean AoVCaSc of 8.00 ± 13.80, and those with an ASCVD risk lower than the 50th percentile had a mean AoVCaSc of 95.00 ± 223.45; p = 0.09. In this study microcalcification, evaluated through 18F-NaF on PET-CT, was related with cardiovascular risk. Although the score of calcium seems to be higher in higher cardiovascular risk patients, no significant difference was found between groups.

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Abbreviations

18F-NaF:

18F-sodium fluoride

AoVCaSc:

Aortic valve calcium score

AoVCUL:

Aortic valve 18F-NaF uptake

ASCVD:

Atherosclerotic cardiovascular disease score from American College of Cardiology

CVR:

Cardiovascular risk

MDRD:

Modification of diet in Renal disease equation

PET-CT:

Positron emission tomography-computed tomography

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Authors and Affiliations

  1. Cardiology, Coimbra Hospital and University Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal

    Célia Domingues, Maria João Ferreira, Manuel Oliveira-Santos, João Pedroso de Lima & Lino Gonçalves

  2. Institute of Nuclear Sciences Applied To Health - University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal

    Maria João Ferreira, Rodolfo Silva, Manuel Oliveira-Santos,  Andreia Gomes, Nuno Chichorro, Miguel Castelo-Branco & Antero Abrunhosa

  3. Faculty of Medicine of the University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal

    Maria João Ferreira, Manuel Oliveira-Santos, Nuno Chichorro, João Pedroso de Lima, Lino Gonçalves, Miguel Castelo-Branco & Antero Abrunhosa

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  1. Célia Domingues
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  2. Maria João Ferreira
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  3. Rodolfo Silva
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  4. Manuel Oliveira-Santos
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Correspondence to Célia Domingues.

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Domingues, C., João Ferreira, M., Silva, R. et al. Aortic valve microcalcification and cardiovascular risk: an exploratory study using sodium fluoride in high cardiovascular risk patients. Int J Cardiovasc Imaging 36, 1593–1598 (2020). https://doi.org/10.1007/s10554-020-01854-0

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  • DOI: https://doi.org/10.1007/s10554-020-01854-0

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