Zhang Xinyuan, Li Hengxin, Niu Xiaoyu, Fu Hang, Xu Rong, Xu Ke, Yuan Weifeng, Xu Ting, Zeng Jiangyao, Zhou Ziqi, Song Yu, Zhang Suming, Guo Yingkun, Huang Shan, Xu Huayan
Department of Radiology, Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, 610041, China.
Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Chengdu, Sichuan, China.
Eur J Nucl Med Mol Imaging. 2025 Apr 2. doi: 10.1007/s00259-025-07217-y.
Our study aims to investigate the associations between stress-related neural activity (SNA), a quantified imaging biomarker in processing stress responses assessed by F-FDG-PET/CT, and cardiovascular (CV) outcomes based on available evidence.
We searched databases from inception to December 1, 2024. Studies assessing the associations between SNA, as quantified by measuring FDG uptake values in the amygdala using F-FDG-PET/CT, and CV outcomes were included. Risk of bias was evaluated using the Newcastle-Ottawa Scale. Random-effects model was implemented for pooled effect sizes (ESs) and heterogeneity evaluation.
Ten studies with 3523 patients with F-FDG-PET/CT were included in our analysis (mean age: 58.5 years; 48.9% female). The ESs included in the analysis comprised hazard ratios (HR) and standardized mean differences (SMD). Among the studies reporting HR, 192 (11.5%) patients experienced composite adverse CV events during a mean follow-up period of 3.8 years. SNA significantly correlated with an increased risk of composite adverse CV events (pooled adjusted HR: 1.61, 95% confidence interval [CI]: 1.12, 2.32). Among the studies reported SMD, individuals experienced composite adverse CV events had significantly higher SNA values than those who did not (Hedges's g = 0.55, 95% CI: 0.14, 0.96).
SNA, as a noninvasive quantified indicator of processing stress responses assessed by brain F-FDG-PET/CT, is associated with an increased risk of CV outcomes. Further research is warranted to validate these findings and to investigate the clinical utility of SNA across various demographic groups.
基于现有证据，我们的研究旨在探讨应激相关神经活动（SNA）（一种通过F-FDG-PET/CT评估应激反应过程中的定量成像生物标志物）与心血管（CV）结局之间的关联。
我们检索了从数据库建立至2024年12月1日的文献。纳入评估通过F-FDG-PET/CT测量杏仁核中FDG摄取值来量化的SNA与CV结局之间关联的研究。使用纽卡斯尔-渥太华量表评估偏倚风险。采用随机效应模型进行合并效应量（ESs）和异质性评估。
我们的分析纳入了10项研究，共3523例接受F-FDG-PET/CT检查的患者（平均年龄：58.5岁；48.9%为女性）。分析中的ESs包括风险比（HR）和标准化均数差（SMD）。在报告HR的研究中，192例（11.5%）患者在平均3.8年的随访期内发生了复合不良CV事件。SNA与复合不良CV事件风险增加显著相关（合并调整后HR：1.61，95%置信区间[CI]：1.12，2.32）。在报告SMD的研究中，发生复合不良CV事件的个体的SNA值显著高于未发生者（Hedges's g = 0.55，95% CI：0.14，0.96）。
SNA作为通过脑F-FDG-PET/CT评估应激反应过程的非侵入性定量指标，与CV结局风险增加相关。有必要进一步开展研究以验证这些发现，并探讨SNA在不同人群中的临床应用价值。
