4149Coronary CT angiography with selective PET perfusion imaging guides referral for invasive coronary angiography and revascularization in coronary artery disease

医学 冠状动脉疾病 血运重建 血管造影 放射科 冠状动脉造影 心肌灌注成像 心脏病学 灌注扫描 内科学 灌注 心肌梗塞
作者
Iida Stenström,Teemu Maaniitty,Valtteri Uusitalo,Heikki Ukkonen,Sami Kajander,M Maki,Jeroen J. Bax,Juhani Knuuti,Antti Saraste
出处
期刊:European Heart Journal [Oxford University Press]
卷期号:38 (suppl_1) 被引量:3
标识
DOI:10.1093/eurheartj/ehx504.4149
摘要

Background:The positron emission tomography (PET) radiotracer 18F-sodium fluoride (18F-NaF) preferentially binds to areas of microcalcification.We have previously demonstrated vascular 18F-NaF uptake in human carotid and coronary atherosclerosis that correlates with necrotic inflammation and plaque rupture.In patients with abdominal aortic aneurysm (AAA), we assessed whether 18F-NaF PET-CT can predict AAA growth and clinical outcomes.Methods: We compared 18F-NaF uptake in normal and aneurysmal aortae between 20 patients with AAA and 20 control volunteers without AAA matched for age, sex and smoking status.In a prospective observational cohort study, 72 patients with AAA >40 mm anteroposterior diameter underwent 18F-NaF PET-CT, CT angiogram and calcium scoring.18F-NaF uptake was quantified using tissueto-background ratio (TBR).Patients with AAA were followed up with ultrasound for at least 1 year.The primary endpoints were aneurysm expansion and the composite of AAA repair or rupture.Results: Higher 18F-NaF uptake was observed within the AAA, both when compared to the controls (p=0.023)and within non-aneurysmal regions of the abdominal aorta in patients with AAA (p=0.004).18F-NaF uptake was similar in the thoracic aorta (p=0.970) and the non-aneurysmal aorta (p=0.911) of patients and controls.In the observational cohort, patients with AAA were predominantly elderly (73±7 years) men (85%) with a baseline aneurysm diameter of 48.8±7.7 mm.During 510±196 days of follow-up, there were 19 aneurysm repairs (26.4%) and 3 ruptures (4.2%).18F-NaF uptake in the most-diseased segment (MDS) of the aneurysm was associated with future growth rate (p=0.006)even after adjustment for age, sex, baseline diameter, blood pressure and body-mass index (p=0.042).Aneurysms in the highest tertile of 18F-NaF uptake expanded 2.5 times more rapidly than those in the lowest tertile (3.10 [3.58] vs 1.24 [2.41] mm/year, p=0.008) and were more than twice as likely to experience AAA repair or rupture (15.3% vs 5.6%, log-rank p=0.043).The association between 18F-NaF uptake (log2MDS TBRmax) and risk of repair or rupture remained even after adjustment for age, sex, gender, blood pressure, body-mass index and aneurysm diameter (HR 2.49, 95% CI1.07, 5.78; p=0.034).In contrast, the CT calcium scoring (Agatston score) was not associated with aneurysm expansion or events (both p>0.05).Conclusions: For the first time, we have demonstrated that 18F-NaF PET-CT is a novel approach to the identification of disease activity in patients with AAA and predicts the rate of aneurysm growth and clinical events, independent of established clinical risk factors including aneurysm diameter.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
chenzy完成签到,获得积分10
1秒前
2秒前
2秒前
dong应助孢子采纳,获得10
3秒前
4秒前
笨笨的傲芙完成签到,获得积分10
5秒前
5秒前
5秒前
5秒前
wcy发布了新的文献求助10
6秒前
Ava应助山东及时雨采纳,获得10
6秒前
6秒前
6秒前
CyS发布了新的文献求助10
6秒前
艺玲发布了新的文献求助10
7秒前
Jasper应助高山我梦采纳,获得10
7秒前
YCW发布了新的文献求助10
8秒前
完美世界应助123456采纳,获得10
8秒前
8秒前
8秒前
loey发布了新的文献求助10
9秒前
左慕山发布了新的文献求助10
9秒前
57完成签到,获得积分20
10秒前
小火苗发布了新的文献求助10
10秒前
11秒前
11秒前
所所应助wcy采纳,获得10
12秒前
14秒前
Xpaper完成签到,获得积分10
14秒前
14秒前
Lili发布了新的文献求助10
15秒前
15秒前
打打应助fyj采纳,获得30
15秒前
蒋瑞轩发布了新的文献求助10
17秒前
今后应助儒雅魂幽采纳,获得10
17秒前
W查查发布了新的文献求助10
17秒前
ziyewutong完成签到,获得积分10
18秒前
思源应助loey采纳,获得10
18秒前
19秒前
Yolo完成签到 ,获得积分10
19秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Effective Learning and Mental Wellbeing 400
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3976107
求助须知:如何正确求助?哪些是违规求助? 3520330
关于积分的说明 11202435
捐赠科研通 3256819
什么是DOI,文献DOI怎么找? 1798504
邀请新用户注册赠送积分活动 877642
科研通“疑难数据库(出版商)”最低求助积分说明 806496