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Sodium fluoride in cardiovascular disorders: A systematic review

  • Review Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

18-Fluorine sodium fluoride is a well-known radiotracer used for bone metastasis diagnosis. Its uptake correlation with cardiovascular (CV) risk was primarily suggested in oncological patients. Moreover, as a specific marker of microcalcification, it seems to correlate with CV disease progression and plaque instability.

Methods and Results

Our purpose was to systematically review clinical studies that characterized the use of this marker in CV conditions. In atherosclerosis, most studies report a positive correlation with the burden of CV risk factors and vascular calcification. A higher uptake was found in culprit plaques/rupture sites in coronary and carotid arteries and it was also linked to high-risk features in histology and intravascular imaging analysis of the plaques. In aortic stenosis, this tracer displayed an increasing uptake with disease severity.

Conclusions

Sodium fluoride positron emission tomography is a promising non-invasive technique to identify high-risk plaques, which sets ground to a potential use of this tracer in evaluating atherosclerotic disease progression and degenerative changes in aortic valve stenosis. Nevertheless, there is a need for further prospective evidence that demonstrates this technique’s value in predicting clinical events, adjusting treatment strategies, and improving patient outcomes.

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Abbreviations

18F-NaF:

Fluorine-18 sodium fluoride

AAA:

Abdominal aortic aneurysm

AVS:

Aortic valve stenosis

CT:

Computed tomography

CV:

Cardiovascular

CVD:

Cardiovascular disease

MI:

Myocardial infarction

PET:

Positron emission tomography

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Authors and Affiliations

  1. Faculdade de Medicina da Universidade de Coimbra, Azinhaga de Santa Comba – Celas PT, 3000-548, Coimbra, Portugal

    Beatriz Isabel Silva Mendes MD, Manuel Oliveira-Santos MD & Maria João Vidigal Ferreira MD, PhD

  2. Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

    Manuel Oliveira-Santos MD & Maria João Vidigal Ferreira MD, PhD

  3. Instituto de Ciências Nucleares Aplicadas à Saúde (ICNAS), Coimbra, Portugal

    Manuel Oliveira-Santos MD & Maria João Vidigal Ferreira MD, PhD

Authors
  1. Beatriz Isabel Silva Mendes MD
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  2. Manuel Oliveira-Santos MD
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  3. Maria João Vidigal Ferreira MD, PhD
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Correspondence to Beatriz Isabel Silva Mendes MD.

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Silva Mendes, B.I., Oliveira-Santos, M. & Vidigal Ferreira, M.J. Sodium fluoride in cardiovascular disorders: A systematic review. J. Nucl. Cardiol. 28, 1461–1473 (2021). https://doi.org/10.1007/s12350-019-01832-7

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  • DOI: https://doi.org/10.1007/s12350-019-01832-7

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