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Impact of cardiovascular risk factors on vessel wall inflammation and calcified plaque burden differs across vascular beds: a PET-CT study

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Abstract

To evaluate the effect of age, gender and cardiovascular risk factors on vessel wall inflammation and the calcified plaque burden in different vascular beds as assessed by PET/CT. 315 patients (mean age: 57.8 years, 123 male and 192 female) who underwent whole body 18F-FDG PET/CT examinations were included in the study. Blood pool-corrected standardised uptake value (TBR) and the calcified plaque score (CPS, grade 0–4) were determined in the thoracic and abdominal aorta, both common carotid and both iliac arteries. The following cardiovascular risk factors were documented: Age ≥65 years (n = 114), male gender (n = 123), diabetes (n = 15), hyperlipidemia (n = 62), hypertension (n = 76), body mass index (BMI) ≥ 30 (n = 38), current smoker (n = 32). Effects of risk factors on TBR and CPS in different arterial beds were assessed using multivariate regression analysis. In the thoracic aorta TBR was independently associated with age ≥65 years and male gender, CPS was independently associated with age ≥65 years, male gender, hypertension and diabetes. In the abdominal aorta, TBR was independently associated with age ≥65 years and male gender, CPS with age ≥65 years, diabetes and smoking. Independent associations in the carotid arteries were found for age ≥65 years, male gender and BMI ≥ 30 in TBR and for age ≥65 and diabetes in CPS. In the iliac arteries, TBR was independently associated with age ≥65 and CPS with age ≥65, male gender, hypertension, diabetes and smoking. Findings of this PET/CT study demonstrate that the impact of cardiovascular risk factors on vessel wall inflammation and calcified plaque burden differs across vascular territories. Overall, CPS was more closely associated with cardiovascular risk factors compared to TBR.

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References

  1. Lloyd-Jones DM, Larson MG, Beiser A, Levy D (1999) Lifetime risk of developing coronary heart disease. Lancet 353(9147):89–92. doi:10.1016/S0140-6736(98)10279-9

    Article  PubMed  CAS  Google Scholar 

  2. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364(9438):937–952. doi:10.1016/S0140-6736(04)17018-9

    Article  PubMed  Google Scholar 

  3. Nordon IM, Hinchliffe RJ, Loftus IM, Thompson MM (2011) Pathophysiology and epidemiology of abdominal aortic aneurysms. Nat Rev Cardiol 8(2):92–102. doi:10.1038/nrcardio.2010.180

    Article  PubMed  Google Scholar 

  4. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG (2007) Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg Off Publ Soci Vasc Surg Int Soc Cardiovasc Surg North American Chapter 45(Suppl S):S5–S67. doi:10.1016/j.jvs.2006.12.037

  5. Rudd JH, Myers KS, Bansilal S, Machac J, Rafique A, Farkouh M, Fuster V, Fayad ZA (2007) (18)Fluorodeoxyglucose positron emission tomography imaging of atherosclerotic plaque inflammation is highly reproducible: implications for atherosclerosis therapy trials. J Am Coll Cardiol 50(9):892–896. doi:10.1016/j.jacc.2007.05.024

    Article  PubMed  Google Scholar 

  6. Rudd JH, Warburton EA, Fryer TD, Jones HA, Clark JC, Antoun N, Johnstrom P, Davenport AP, Kirkpatrick PJ, Arch BN, Pickard JD, Weissberg PL (2002) Imaging atherosclerotic plaque inflammation with [18F]-fluorodeoxyglucose positron emission tomography. Circulation 105(23):2708–2711

    Article  PubMed  CAS  Google Scholar 

  7. Tawakol A, Migrino RQ, Bashian GG, Bedri S, Vermylen D, Cury RC, Yates D, LaMuraglia GM, Furie K, Houser S, Gewirtz H, Muller JE, Brady TJ, Fischman AJ (2006) In vivo 18F-fluorodeoxyglucose positron emission tomography imaging provides a noninvasive measure of carotid plaque inflammation in patients. J Am Coll Cardiol 48(9):1818–1824. doi:10.1016/j.jacc.2006.05.076

    Article  PubMed  Google Scholar 

  8. Vancraeynest D, Pasquet A, Roelants V, Gerber BL, Vanoverschelde JL (2011) Imaging the vulnerable plaque. J Am Coll Cardiol 57(20):1961–1979. doi:10.1016/j.jacc.2011.02.018

    Article  PubMed  Google Scholar 

  9. Eisen A, Tenenbaum A, Koren-Morag N, Tanne D, Shemesh J, Imazio M, Fisman EZ, Motro M, Schwammenthal E, Adler Y (2008) Calcification of the thoracic aorta as detected by spiral computed tomography among stable angina pectoris patients: association with cardiovascular events and death. Circulation 118(13):1328–1334. doi:10.1161/CIRCULATIONAHA.107.712141

    Article  PubMed  Google Scholar 

  10. Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH, Flores FR, Callister TQ, Raggi P, Berman DS (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49(18):1860–1870. doi:10.1016/j.jacc.2006.10.079

    Article  PubMed  Google Scholar 

  11. Bucerius J, Duivenvoorden R, Mani V, Moncrieff C, Rudd JH, Calcagno C, Machac J, Fuster V, Farkouh ME, Fayad ZA (2011) Prevalence and risk factors of carotid vessel wall inflammation in coronary artery disease patients: FDG-PET and CT imaging study. JACC Cardiovasc Imag 4(11):1195–1205. doi:10.1016/j.jcmg.2011.07.008

    Article  Google Scholar 

  12. Tahara N, Kai H, Yamagishi S, Mizoguchi M, Nakaura H, Ishibashi M, Kaida H, Baba K, Hayabuchi N, Imaizumi T (2007) Vascular inflammation evaluated by [18F]-fluorodeoxyglucose positron emission tomography is associated with the metabolic syndrome. J Am Coll Cardiol 49(14):1533–1539. doi:10.1016/j.jacc.2006.11.046

    Article  PubMed  CAS  Google Scholar 

  13. Rudd JH, Myers KS, Bansilal S, Machac J, Woodward M, Fuster V, Farkouh ME, Fayad ZA (2009) Relationships among regional arterial inflammation, calcification, risk factors, and biomarkers: a prospective fluorodeoxyglucose positron-emission tomography/computed tomography imaging study. Circ Cardiovasc Imag 2(2):107–115. doi:10.1161/CIRCIMAGING.108.811752

    Article  Google Scholar 

  14. Rominger A, Saam T, Wolpers S, Cyran CC, Schmidt M, Foerster S, Nikolaou K, Reiser MF, Bartenstein P, Hacker M (2009) 18F-FDG PET/CT identifies patients at risk for future vascular events in an otherwise asymptomatic cohort with neoplastic disease. J Nucl Med Off Publ Soc Nucl Med 50(10):1611–1620. doi:10.2967/jnumed.109.065151

    Google Scholar 

  15. CAPRIE Steering Committee (1996) A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 348(9038):1329–1339

    Google Scholar 

  16. Rudd JH, Myers KS, Bansilal S, Machac J, Pinto CA, Tong C, Rafique A, Hargeaves R, Farkouh M, Fuster V, Fayad ZA (2008) Atherosclerosis inflammation imaging with 18F-FDG PET: carotid, iliac, and femoral uptake reproducibility, quantification methods, and recommendations. J Nucl Med Off Publ Soc Nucl Med 49(6):871–878. doi:10.2967/jnumed.107.050294

    Google Scholar 

  17. Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE Jr, Eagle KA, Hermann LK, Isselbacher EM, Kazerooni EA, Kouchoukos NT, Lytle BW, Milewicz DM, Reich DL, Sen S, Shinn JA, Svensson LG, Williams DM (2010) 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Catheter Cardiovasc Interv Off J Soc Cardiac Angiogr Interv 76(2):E43–E86

  18. Isselbacher EM (2005) Thoracic and abdominal aortic aneurysms. Circulation 111(6):816–828. doi:10.1161/01.CIR.0000154569.08857.7A

    Article  PubMed  Google Scholar 

  19. Tunick PA, Rosenzweig BP, Katz ES, Freedberg RS, Perez JL, Kronzon I (1994) High risk for vascular events in patients with protruding aortic atheromas: a prospective study. J Am Coll Cardiol 23(5):1085–1090

    Article  PubMed  CAS  Google Scholar 

  20. Mitusch R, Doherty C, Wucherpfennig H, Memmesheimer C, Tepe C, Stierle U, Kessler C, Sheikhzadeh A (1997) Vascular events during follow-up in patients with aortic arch atherosclerosis. Stroke J Cereb Circ 28(1):36–39

    Article  CAS  Google Scholar 

  21. Davila-Roman VG, Murphy SF, Nickerson NJ, Kouchoukos NT, Schechtman KB, Barzilai B (1999) Atherosclerosis of the ascending aorta is an independent predictor of long-term neurologic events and mortality. J Am Coll Cardiol 33(5):1308–1316

    Article  PubMed  CAS  Google Scholar 

  22. Cohen A, Tzourio C, Amarenco P (1997) Evaluation of aortic atherosclerosis by transesophageal echocardiography. Prognostic implications. Archives des maladies du coeur et des vaisseaux 90 Spec No 2:11–23

    Google Scholar 

  23. Dunphy MP, Freiman A, Larson SM, Strauss HW (2005) Association of vascular 18F-FDG uptake with vascular calcification. J Nucl Med Off Publ Soc Nucl Med 46(8):1278–1284

    Google Scholar 

  24. Truijers M, Kurvers HA, Bredie SJ, Oyen WJ, Blankensteijn JD (2008) In vivo imaging of abdominal aortic aneurysms: increased FDG uptake suggests inflammation in the aneurysm wall. J Endovascular Ther Off J Int Soc Endovascular Specialists 15(4):462–467. doi:10.1583/08-2447.1

    Article  Google Scholar 

  25. Sarda-Mantel L, Alsac JM, Boisgard R, Hervatin F, Montravers F, Tavitian B, Michel JB, Le Guludec D (2012) Comparison of 18F-fluoro-deoxy-glucose, 18F-fluoro-methyl-choline, and 18F-DPA714 for positron-emission tomography imaging of leukocyte accumulation in the aortic wall of experimental abdominal aneurysms. J Vasc Surg Off Publ Soc Vasc Surg Int Soc Cardiovasc Surg North American Chapter 56(3):765–773. doi:10.1016/j.jvs.2012.01.069

  26. Bickerstaff LK, Pairolero PC, Hollier LH, Melton LJ, Van Peenen HJ, Cherry KJ, Joyce JW, Lie JT (1982) Thoracic aortic aneurysms: a population-based study. Surgery 92(6):1103–1108

    PubMed  CAS  Google Scholar 

  27. Koch AE, Haines GK, Rizzo RJ, Radosevich JA, Pope RM, Robinson PG, Pearce WH (1990) Human abdominal aortic aneurysms. Immunophenotypic analysis suggesting an immune-mediated response. Am J Pathol 137(5):1199–1213

    PubMed  CAS  Google Scholar 

  28. Newman KM, Jean-Claude J, Li H, Ramey WG, Tilson MD (1994) Cytokines that activate proteolysis are increased in abdominal aortic aneurysms. Circulation 90(5 Pt 2):II224–II227

    Google Scholar 

  29. Marnane M, Merwick A, Sheehan OC, Hannon N, Foran P, Grant T, Dolan E, Moroney J, Murphy S, O’Rourke K, O’Malley K, O’Donohoe M, McDonnell C, Noone I, Barry M, Crowe M, Kavanagh E, O’Connell M, Kelly PJ (2012) Carotid plaque inflammation on 18F-fluorodeoxyglucose positron emission tomography predicts early stroke recurrence. Ann Neurol 71(5):709–718. doi:10.1002/ana.23553

    Article  PubMed  Google Scholar 

  30. Saam T, Rominger A, Wolpers S, Nikolaou K, Rist C, Greif M, Cumming P, Becker A, Foerster S, Reiser MF, Bartenstein P, Hacker M (2010) Association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors, plaque burden and pericardial fat volume: a PET/CT study. Eur J Nucl Med Mol Imag 37(6):1203–1212. doi:10.1007/s00259-010-1432-2

    Article  Google Scholar 

  31. Kerwin WS, Oikawa M, Yuan C, Jarvik GP, Hatsukami TS (2008) MR imaging of adventitial vasa vasorum in carotid atherosclerosis. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 59(3):507–514. doi:10.1002/mrm.21532

    Article  CAS  Google Scholar 

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Correspondence to Tobias Saam.

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Strobl, F.F., Rominger, A., Wolpers, S. et al. Impact of cardiovascular risk factors on vessel wall inflammation and calcified plaque burden differs across vascular beds: a PET-CT study. Int J Cardiovasc Imaging 29, 1899–1908 (2013). https://doi.org/10.1007/s10554-013-0277-8

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  • DOI: https://doi.org/10.1007/s10554-013-0277-8

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