Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA.
National Institutes of Health Clinical Center, 10 Center Drive, Clinical Research Center, Bethesda, MD, 20892, USA.
Eur J Nucl Med Mol Imaging. 2019 Nov;46(12):2488-2495. doi: 10.1007/s00259-019-04454-w. Epub 2019 Aug 5.
The contribution of inflammation to the incidence of cardiovascular disease (CVD) has been increasingly recognized in recent years. We investigated the relationship of aortic vascular uptake of 18F-FDG by PET/CT and aortic wall thickness (AWT) by MRI in psoriasis, a chronic inflammatory disease with increased incidence of CVD. One hundred sixty-five patients with plaque psoriasis participated in an ongoing longitudinal cohort study. Subclinical atherosclerosis was assessed as aortic uptake of 18F-FDG by PET/CT reported as target-to-background ratio (TBR) and AWT by MRI reported as maximal thickness.
Patients with psoriasis were middle aged, predominantly male, and had mild CV risk by traditional risk factors. Psoriasis severity as measured by PASI score was a notable determinant of AWT (ρ = 0.20, p = 0.01). Moreover, aortic vascular uptake of 18F-FDG associated with AWT by MRI at baseline in unadjusted analysis (β = 0.27 p = 0.001) and following adjustment for traditional cardiovascular risk factors, waist-to-hip ratio, and statin use (β = 0.21 p = 0.01). Finally, following 1 year of psoriasis treatment, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT in fully adjusted models (β = 0.33, p = 0.02).
In conclusion, we demonstrate that psoriasis severity and aortic vascular uptake of 18F-FDG in the aorta were associated with AWT. Following treatment of psoriasis, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT at 1 year. These findings suggest that aortic vascular uptake of 18F-FDG is associated with early evidence of vascular disease assessed by aortic wall thickness. Prospective studies in larger populations including other inflammatory diseases are warranted.
近年来，炎症对心血管疾病（CVD）发病率的影响越来越受到重视。我们研究了银屑病患者的主动脉 18F-FDG 摄取与 MRI 测量的主动脉壁厚度（AWT）之间的关系。银屑病是一种慢性炎症性疾病，CVD 发病率增加。165 例斑块状银屑病患者参与了一项正在进行的纵向队列研究。采用 PET/CT 检测主动脉摄取 18F-FDG 作为靶标与背景比（TBR），MRI 检测 AWT 作为最大厚度来评估亚临床动脉粥样硬化。
银屑病患者年龄居中，主要为男性，传统危险因素评估的 CV 风险较低。PASI 评分测量的银屑病严重程度是 AWT 的显著决定因素（ρ=0.20，p=0.01）。此外，在未校正分析中，基线时主动脉 18F-FDG 摄取与 MRI 测量的 AWT 相关（β=0.27，p=0.001），在校正传统心血管危险因素、腰围臀围比和他汀类药物使用后仍相关（β=0.21，p=0.01）。最后，在银屑病治疗 1 年后，主动脉 18F-FDG 摄取的减少与 AWT 的降低相关，在完全校正模型中，两者相关（β=0.33，p=0.02）。
总之，我们证明了银屑病严重程度和主动脉 18F-FDG 摄取与 AWT 相关。银屑病治疗后，主动脉 18F-FDG 摄取的减少与 1 年后 AWT 的降低相关。这些发现表明，主动脉 18F-FDG 摄取与通过主动脉壁厚度评估的早期血管疾病证据相关。需要在包括其他炎症性疾病在内的更大人群中开展前瞻性研究。
