Abstract
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Objectives: Atherosclerosis and subsequent hypertension are major preventable causes of morbidity and mortality worldwide. Atherogenesis in the aorta, coronary arteries, and carotid arteries have previously been quantified using 18F-sodium fluoride positron emission tomography/computed tomography (NaF-PET/CT). In the present study, we aim to 1) demonstrate the role of NaF-PET/CT in pulmonary artery atherosclerosis and 2) compare atherosclerosis to systemic hypertension. Specifically, we developed a novel methodology to stratified patients based on systemic blood pressure (diastolic and systolic); then in each stratum, we compared pulmonary artery NaF uptake healthy subjects and those with cardiovascular risk.
Methods: The present study examined 15 subjects with increased risk for cardiovascular disease (“at-risk”) and 15 healthy controls from the CAMONA study conducted at Odense University Hospital (NCT01724749). Both subject groups underwent PET/CT imaging at the identical time point of 90 minutes following NaF injection- there was no significant difference in timing between administration of NaF and PET imaging for the two groups.Regions of interest (ROIs) were manually delineated around the lumen of the pulmonary artery (right, left, and main branches). Average standardized uptake value (aSUV) was calculated by standard formula. Subjects were stratified by average systolic and diastolic pressures. Wilcoxon’s rank-sum test was used to assess the differences in aSUV between healthy controls and at-risk subjects in each blood pressure stratum.
Results: In each diastolic blood pressure stratum, at-risk patients displayed higher levels of pulmonary artery NaF uptake (p<.05for each category) (Figure 1). Similarly, in each systolic blood pressure stratum, in every category, the at-risk patients displayed higher levels of pulmonary artery NaF uptake (p<.05for each category) (Figure 2).
Conclusions: Our study shows that cardiovascular disease and subsequent pulmonary artery atherosclerosis can be detected and quantified by NaF-PET/CT, as evidenced by increased pulmonary artery NaF uptake. However, we did not observe overall greater NaF uptake in higher systemic blood pressure strata. Additional well-powered studies are needed to better define the relationship between pulmonary artery atherosclerosis and systemic hypertension.