冠心病患者颈动脉血管壁炎症的患病率及危险因素：FDG-PET 和 CT 影像学研究。
Prevalence and risk factors of carotid vessel wall inflammation in coronary artery disease patients: FDG-PET and CT imaging study.
机构信息
Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, New York, New York 10029, USA.
出版信息
JACC Cardiovasc Imaging. 2011 Nov;4(11):1195-205. doi: 10.1016/j.jcmg.2011.07.008.
OBJECTIVES
We investigated the prevalence and clinical risk factors of carotid vessel wall inflammation by means of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in a population consisting of coronary artery disease (CAD) patients.
BACKGROUND
The atherosclerotic disease process is characterized by infiltration and retention of oxidized lipids in the artery wall, triggering a disproportionate inflammatory response. Efforts have been made to use noninvasive imaging to quantify this inflammatory response in the vessel wall. Recently, carotid FDG-PET has been shown to reflect the metabolic rate of glucose, a process known to be enhanced in inflamed tissue.
METHODS
Carotid inflammation was quantified in 82 CAD patients (age 62 ± 10 years) as the maximum target-to-background ratio ((wholevessel)TBR(max)). Furthermore, we assessed the maximal standardized uptake value values ((wholevessel)SUV(max)), the single hottest segment (SHS), and the percent active segments (PAS) of the FDG uptake in the artery wall, measured by FDG-PET.
RESULTS
Whole-vessel TBR(max) >1.8 was present in 67%, >2.0 in 39%, >2.2 in 23%, and >2.4 in 12% of the population. Multiple linear regression analysis with backward elimination revealed that body mass index (BMI) ≥30 kg/m2 (p < 0.0001), age >65 years (p = 0.01), smoking (p = 0.02), and hypertension (p = 0.01) were associated with (wholevessel)TBR(max). The number of components of the metabolic syndrome was also associated with (wholevessel)TBR(max) (p = 0.02). In similar analyses, (wholevessel)SUV(max) was associated with BMI ≥30 kg/m2 (p < 0.0001), age >65 years (p = 0.004), male gender (p = 0.02), and hypertension (p = 0.04); SHS with BMI ≥30 kg/m2 (p < 0.0001), age >65 years (p = 0.02), smoking (p = 0.04), and hypertension (p = 0.05); PAS with BMI ≥30 kg/m2 (p = 0.001), smoking (p = 0.03), and hypertension (p = 0.01).
CONCLUSIONS
Carotid inflammation as revealed by FDG-PET is highly prevalent in the CAD population and is associated with obesity, age over 65 years, history of hypertension, smoking, and male gender. Artery wall FDG uptake increased when components of the metabolic syndrome clustered.
目的
通过 18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）研究冠状动脉疾病（CAD）患者人群中颈动脉血管壁炎症的流行情况和临床危险因素。
背景
动脉粥样硬化疾病的特征是氧化脂质在动脉壁中的浸润和滞留，引发不成比例的炎症反应。人们一直在努力使用非侵入性成像技术来量化血管壁中的这种炎症反应。最近，颈动脉 FDG-PET 已被证明反映了葡萄糖的代谢率，这一过程在炎症组织中得到增强。
方法
我们在 82 名 CAD 患者（年龄 62 ± 10 岁）中定量评估了颈动脉炎症，其方法是计算最大靶标与背景比（（整个血管）TBR(max)）。此外，我们还评估了 FDG-PET 测量的动脉壁 FDG 摄取的最大标准化摄取值（（整个血管）SUV(max)）、单个最热点段（SHS）和活性段百分比（PAS）。
结果
整个血管 TBR(max) >1.8 的占 67%，>2.0 的占 39%，>2.2 的占 23%，>2.4 的占 12%。采用向后消除的多元线性回归分析显示，体重指数（BMI）≥30 kg/m2（p < 0.0001）、年龄>65 岁（p = 0.01）、吸烟（p = 0.02）和高血压（p = 0.01）与（整个血管）TBR(max)相关。代谢综合征的组成部分数量也与（整个血管）TBR(max)相关（p = 0.02）。在类似的分析中，（整个血管）SUV(max)与 BMI≥30 kg/m2（p < 0.0001）、年龄>65 岁（p = 0.004）、男性（p = 0.02）和高血压（p = 0.04）相关；SHS 与 BMI≥30 kg/m2（p < 0.0001）、年龄>65 岁（p = 0.02）、吸烟（p = 0.04）和高血压（p = 0.05）相关；PAS 与 BMI≥30 kg/m2（p = 0.001）、吸烟（p = 0.03）和高血压（p = 0.01）相关。
结论
在 CAD 人群中，FDG-PET 显示的颈动脉炎症发病率很高，与肥胖、年龄超过 65 岁、高血压病史、吸烟和男性有关。当代谢综合征的组成部分聚集时，动脉壁 FDG 摄取增加。
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