Impact of cardiovascular risk factors on vessel wall inflammation and calcified plaque burden differs across vascular beds: a PET-CT study Frederik F. StroblAxel RomingerSarah WolpersCarsten Rist • Fabian BambergKolja M. ThierfelderKonstantin Nikolaou • Christopher UebleisMarcus HackerMaximilian F.

To evaluate the effect of age, gender and car- diovascular 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 C65 years (n = 114), male gender (n = 123), diabetes (n = 15), hyperlipidemia (n = 62), hypertension (n = 76), body mass index (BMI) C 30 (n = 38), current smoker (n = 32). Effects of risk factors on TBR and CPS in dif- ferent arterial beds were assessed using multivariate regression analysis. In the thoracic aorta TBR was inde- pendently associated with age C65 years and male gender, CPS was independently associated with age C65 years, male gender, hypertension and diabetes. In the abdominal aorta, TBR was independently associated with age C65 years and male gender, CPS with age C65 years, diabetes and smoking. Independent associations in the carotid arteries were found for age C65 years, male gender and BMI C 30 in TBR and for age C65 and diabetes in CPS. In the iliac arteries, TBR was independently associated with age C65 and CPS with age C65, 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 com- pared to TBR.

[1]  J. Alsac,et al.  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. , 2012, Journal of vascular surgery.

[2]  E. Dolan,et al.  Carotid plaque inflammation on 18F‐fluorodeoxyglucose positron emission tomography predicts early stroke recurrence , 2012, Annals of neurology.

[3]  Claudia Calcagno,et al.  Prevalence and risk factors of carotid vessel wall inflammation in coronary artery disease patients: FDG-PET and CT imaging study. , 2011, JACC. Cardiovascular imaging.

[4]  Agnes Pasquet,et al.  Imaging the vulnerable plaque. , 2011, Journal of the American College of Cardiology.

[5]  Robert J. Hinchliffe,et al.  Pathophysiology and epidemiology of abdominal aortic aneurysms , 2011, Nature Reviews Cardiology.

[6]  M. Reiser,et al.  Association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors, plaque burden and pericardial fat volume: a PET/CT study , 2010, European Journal of Nuclear Medicine and Molecular Imaging.

[7]  David M. Williams,et al.  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 Th , 2010, Anesthesia and analgesia.

[8]  M. Reiser,et al.  18F-FDG PET/CT Identifies Patients at Risk for Future Vascular Events in an Otherwise Asymptomatic Cohort with Neoplastic Disease , 2009, Journal of Nuclear Medicine.

[9]  V. Fuster,et al.  Relationships Among Regional Arterial Inflammation, Calcification, Risk Factors, and Biomarkers: A Prospective Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Imaging Study , 2009, Circulation. Cardiovascular imaging.

[10]  Michael Motro,et al.  Calcification of the Thoracic Aorta as Detected by Spiral Computed Tomography Among Stable Angina Pectoris Patients: Association With Cardiovascular Events and Death , 2008, Circulation.

[11]  W. Oyen,et al.  In Vivo Imaging of Abdominal Aortic Aneurysms: Increased FDG Uptake Suggests Inflammation in the Aneurysm Wall , 2008, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[12]  Sameer Bansilal,et al.  Atherosclerosis Inflammation Imaging with 18F-FDG PET: Carotid, Iliac, and Femoral Uptake Reproducibility, Quantification Methods, and Recommendations , 2008, Journal of Nuclear Medicine.

[13]  W S Kerwin,et al.  MR imaging of adventitial vasa vasorum in carotid atherosclerosis , 2008, Magnetic resonance in medicine.

[14]  V. Fuster,et al.  (18)Fluorodeoxyglucose positron emission tomography imaging of atherosclerotic plaque inflammation is highly reproducible: implications for atherosclerosis therapy trials. , 2007, Journal of the American College of Cardiology.

[15]  Daniel S Berman,et al.  Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. , 2007, Journal of the American College of Cardiology.

[16]  T. Imaizumi,et al.  Vascular inflammation evaluated by [18F]-fluorodeoxyglucose positron emission tomography is associated with the metabolic syndrome. , 2007, Journal of the American College of Cardiology.

[17]  Ahmed Tawakol,et al.  In vivo 18F-fluorodeoxyglucose positron emission tomography imaging provides a noninvasive measure of carotid plaque inflammation in patients. , 2006, Journal of the American College of Cardiology.

[18]  A. Freiman,et al.  Association of vascular 18F-FDG uptake with vascular calcification. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[19]  E. Isselbacher.  Thoracic and Abdominal Aortic Aneurysms , 2005, Circulation.

[20]  S. Yusuf,et al.  Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study , 2004, The Lancet.

[21]  J. Pickard,et al.  Imaging Atherosclerotic Plaque Inflammation With [18F]-Fluorodeoxyglucose Positron Emission Tomography , 2002, Circulation.

[22]  N. Kouchoukos,et al.  Atherosclerosis of the ascending aorta is an independent predictor of long-term neurologic events and mortality. , 1999, Journal of the American College of Cardiology.

[23]  Daniel Levy,et al.  Lifetime risk of developing coronary heart disease , 1999, The Lancet.

[24]  C. Tzourio,et al.  [Evaluation of aortic atherosclerosis by transesophageal echocardiography. Prognostic implications]. , 1997, Archives des maladies du coeur et des vaisseaux.

[25]  K. Newman,et al.  Cytokines that activate proteolysis are increased in abdominal aortic aneurysms. , 1994, Circulation.

[26]  I. Kronzon,et al.  High Risk for Vascular Events in Patients with Protruding Aortic Atheromas: A Prospective Study , 1994, Journal of the American College of Cardiology.

[27]  W. Pearce,et al.  Human abdominal aortic aneurysms. Immunophenotypic analysis suggesting an immune-mediated response. , 1990, The American journal of pathology.

[28]  L. Melton,et al.  Thoracic aortic aneurysms: a population-based study. , 1982, Surgery.

[29]  L. Norgren,et al.  Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). , 2007, Journal of vascular surgery.

[30]  C. Doherty,et al.  Vascular events during follow-up in patients with aortic arch atherosclerosis. , 1997, Stroke.

[31]  D. Clement.  A randomised, blinded, trial of Clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE) , 1996 .