Document Detail


Feasibility of FDG imaging of the coronary arteries: comparison between acute coronary syndrome and stable angina.
MedLine Citation:
PMID:  20394901     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study tested the hypothesis that fluorodeoxyglucose (FDG) uptake within the ascending aorta and left main coronary artery (LM), measured using positron emission tomography (PET), is greater in patients with recent acute coronary syndrome (ACS) than in patients with stable angina. BACKGROUND: Inflammation is known to play an important role in atherosclerosis. Positron emission tomography imaging with (18)F-FDG provides a measure of plaque inflammation. METHODS: Twenty-five patients (mean age 57.9 +/- 9.8 years, 72% male, 10 ACS, and 15 stable angina) underwent cardiac computed tomographic angiography and PET imaging with (18)F-FDG after invasive angiography. Images were coregistered, and FDG uptake was measured at locations of interest for calculation of target-to-background ratios (TBR). Additionally, FDG uptake was measured at the site of the lesion deemed clinically responsible for the presenting syndrome (culprit) by virtue of locating the stent deployed to treat the syndrome. RESULTS: The FDG uptake was higher in the ACS versus the stable angina groups in the ascending aorta (median [interquartile ranges] TBR 3.30 [2.69 to 4.12] vs. 2.43 [2.00 to 2.86], p = 0.02), as well as the LM (2.48 [2.30 to 2.93] vs. 2.00 [1.71 to 2.44], p = 0.03, respectively). The TBR was greater for culprit lesions associated with ACS than for lesions stented for stable coronary syndromes (2.61 vs. 1.74, p = 0.02). Furthermore, the TBR in the stented lesions (in ACS and stable angina groups) correlated with C-reactive protein (r = 0.58, p = 0.04). CONCLUSIONS: This study shows that in patients with recent ACS, FDG accumulation is increased both within the culprit lesion as well as in the ascending aorta and LM. This observation suggests inflammatory activity within atherosclerotic plaques in acute coronary syndromes and supports intensification of efforts to refine PET methods for molecular imaging of coronary plaques.
Authors:
Ian S Rogers; Khurram Nasir; Amparo L Figueroa; Ricardo C Cury; Udo Hoffmann; David A Vermylen; Thomas J Brady; Ahmed Tawakol
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  3     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-16     Completed Date:  2010-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  388-97     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / etiology,  radionuclide imaging*
Aged
Angina Pectoris / etiology,  radionuclide imaging*
Angina, Unstable / etiology,  radionuclide imaging*
Aorta / radionuclide imaging
Biological Markers / blood
Coronary Angiography / methods
Coronary Artery Disease / complications,  radionuclide imaging*
Feasibility Studies
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Male
Middle Aged
Positron-Emission Tomography*
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use*
Reproducibility of Results
Tomography, X-Ray Computed
Grant Support
ID/Acronym/Agency:
T32HL076136/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections
Comment In:
JACC Cardiovasc Imaging. 2010 Apr;3(4):448-50   [PMID:  20394909 ]

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