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Peri-Coronary Adipose Tissue Density Is Associated With 18F-Sodium Fluoride Coronary Uptake in Stable Patients With High-Risk Plaques.


ABSTRACT: OBJECTIVES:This study aimed to assess the association between increased lesion peri-coronary adipose tissue (PCAT) density and coronary 18F-sodium fluoride (18F-NaF) uptake on positron emission tomography (PET) in stable patients with high-risk coronary plaques (HRPs) shown on coronary computed tomography angiography (CTA). BACKGROUND:Coronary 18F-NaF uptake reflects the rate of calcification of coronary atherosclerotic plaque. Increased PCAT density is associated with vascular inflammation. Currently, the relationship between increased PCAT density and 18F-NaF uptake in stable patients with HRPs on coronary CTA has not been characterized. METHODS:Patients who underwent coronary CTA were screened for HRP, which was defined by 3 concurrent plaque features: positive remodeling; low attenuation plaque (LAP) (<30 Hounsfield units [HU]) and spotty calcification; and obstructive coronary stenosis ?50% (plaque volume >100 mm3). Patients with HRPs were recruited to undergo 18F-NaF PET/CT. In lesions with stenosis ?25%, quantitative plaque analysis, mean PCAT density, maximal coronary motion-corrected 18F-NaF standard uptake values (SUVmax), and target-to-background ratios (TBR) were measured. RESULTS:Forty-one patients (age 65 ± 6 years; 68% men) were recruited. Fifty-one lesions in 23 patients (56%) showed increased coronary 18F-NaF activity. Lesions with 18F-NaF uptake had higher surrounding PCAT density than those without 18F-NaF uptake (-73 HU; interquartile range -79 to -68 HU vs. -86 HU; interquartile range -94 to -80 HU; p < 0.001). 18F-NaF TBR and SUVmax were correlated with PCAT density (r = 0.63 and r = 0.68, respectively; all p < 0.001). On adjusted multiple regression analysis, increased lesion PCAT density and LAP volume were associated with 18F-NaF TBR (? = 0.25; 95% confidence interval: 0.17 to 0.34; p < 0.001 for PCAT, and ? = 0.07; 95% confidence interval: 0.03 to 0.11; p = 0.002 for LAP). CONCLUSIONS:In patients with HRP features on coronary CTA, increased density of PCAT was associated with focal 18F-NaF PET uptake. Simultaneous assessment of these imaging biomarkers by 18F-NaF PET and CTA might refine cardiovascular risk prediction in stable patients with HRP features.

SUBMITTER: Kwiecinski J 

PROVIDER: S-EPMC6689460 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Peri-Coronary Adipose Tissue Density Is Associated With <sup>18</sup>F-Sodium Fluoride Coronary Uptake in Stable Patients With High-Risk Plaques.

Kwiecinski Jacek J   Dey Damini D   Cadet Sebastien S   Lee Sang-Eun SE   Otaki Yuka Y   Huynh Phi T PT   Doris Mhairi K MK   Eisenberg Evann E   Yun Mijin M   Jansen Maurits A MA   Williams Michelle C MC   Tamarappoo Balaji K BK   Friedman John D JD   Dweck Marc R MR   Newby David E DE   Chang Hyuk-Jae HJ   Slomka Piotr J PJ   Berman Daniel S DS  

JACC. Cardiovascular imaging 20190213 10


<h4>Objectives</h4>This study aimed to assess the association between increased lesion peri-coronary adipose tissue (PCAT) density and coronary <sup>18</sup>F-sodium fluoride (<sup>18</sup>F-NaF) uptake on positron emission tomography (PET) in stable patients with high-risk coronary plaques (HRPs) shown on coronary computed tomography angiography (CTA).<h4>Background</h4>Coronary <sup>18</sup>F-NaF uptake reflects the rate of calcification of coronary atherosclerotic plaque. Increased PCAT densi  ...[more]

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