Abstract P390: Insulin Resistance Determines Severity of Vascular Inflammation by 18-Fluorodeoxy Glucose PET-CT in Psoriasis

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Balaji Natarajan ◽  
Taufiq Salahuddin ◽  
Jenny Dave ◽  
Martin Playford ◽  
Julia Doveikis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Nmr Spectroscopy ◽  
Lipid Profile ◽  
Fdg Pet ◽  
Vascular Inflammation ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Pet Ct ◽  
Fdg Pet Ct

Introduction: Psoriasis (PSO), an inflammatory skin disease is associated with increased cardiovascular disease (CVD) risk. We have previously shown the presence of insulin resistance (IR) in psoriasis, however how this relates to subclinical vascular disease is unknown. Here, our aim was to determine whether IR relates to vascular inflammation (VI) measured by 18 FDG PET-CT in a well-phenotyped psoriasis cohort (NCT 01778569). Hypothesis: We assessed the hypothesis that an increase in IR is associated with greater VI. Methods: We performed 18 FDG PET-CT scans on 86 consecutive patients with psoriasis (Siemens Biograph). Target-to-background ratio (TBR) was used as the VI measure. Fasting plasma samples were collected and homeostatic model assessment of IR (HOMA-IR) was used to stratify the study group into normal (n=41) vs high (n=45) HOMA-IR groups using an accepted cut-off value (3.0). Lipid profile and lipoprotein characteristics were also obtained using NMR spectroscopy (Liposcience, USA). Results: Our study cohort was middle aged with mild to moderate PSO (Table 1). There was increased VI by TBR in this sample (mean 1.8±0.3) as compared to published values for CAD (mean 1.6±0.3). The high HOMA-IR group had greater skin involvement by psoriasis, an increased incidence of CVD risk factors and an atherogenic lipid profile on NMR spectroscopy when compared to the normal HOMA-IR group. There was greater VI in the high HOMA-IR group (Mean±SD: 1.91±0.3 vs 1.69±0.2, p<0.001) which was robust to multivariate adjustment for age, gender, CVD risk factors and BMI (beta 0.38, p <0.01). Finally, on likelihood ratio testing, we observed an incremental effect when HOMA-IR was added to a fully adjusted model with BMI as a covariate (chi 2 5.65, p = 0.02). Conclusion: Psoriasis increases VI by 18 FDG PET-CT, which is strongly related to the presence of IR beyond traditional CVD risk factors and BMI. This suggests that inflammatory IR may have direct impact on the development of vascular inflammation.

scholarly journals POS0096 SPLENIC METABOLIC UPTAKE IN FDG-PET/CT PREDICTS RISK OF FUTURE CARDIOVASCULAR THROMBOSIS EVENTS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 258.2-259
Author(s):  
S. J. Lee ◽  
C. M. Hong ◽  
Y. M. Kang
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Disease Activity ◽  
Fdg Pet ◽  
Cvd Risk ◽  
Positron Emission ◽  
Increased Risk ◽  
Pet Ct ◽  
Fdg Pet Ct

Background:Patients with the rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) compared to general population. However there are insufficient modality to predict future CVD risk in RA.Objectives:This study assessed whether splenic and arterial activity measured by positron emission tomography/ computed tomography (PET/CT) predict the risk of CVD thrombosis events beyond conventional risk factors in patients with RA.Methods:We enrolled 84 patients with active RA who underwent fluorine-18-fluorodeoxyglucose (FDG) PET/CT and disease activity evaluation at the same time. CVD thrombosis events were independently evaluated, while blinded to activity of PET/CT, during follow up periods. FDG uptake by nuclear medicine physician was examined in the spleen and ascending aorta and blood pool activity of superior vena cava as SUV (standardized uptake values) and target-to-background-ratio (TBR) while blinded to CVD events.Results:During follow-up periods, 19 patients developed CVD thrombosis events. Both splenic and arterial TBR were significantly increased in patients with subsequent CVD events compared to in patients without (2.19 ± 0.60 vs 1.80 ± 0.34, p < 0.013, 1.72 ± 0.22 vs 1.57 ± 0.22, p< 0.012). Splenic TBR was associated with an increased risk of CVD events after adjustment for conventional CVD risk factors [hazard ratio (HR): 3.15; 95% confidence interval (CI): 1.46 to 6.79; p = 0.003]. Moreover, the association between splenic TBR and CVD events remained significant after adjustment for disease activity (HR: 3.00; CI: 1.36 to 6.63; p = 0.007) and after adjustment for arterial TBR (HR: 3.00; CI: 1.36 to 6.63; p = 0.007).Conclusion:Our results show splenic metabolic uptake in FDG-PET/CT in patients with RA provide information for subsequent CVD events beyond conventional risk factors.References:[1]Lee SJ, Jeong JH, Lee CH, et al. Development and validation of an (18) F-fluorodeoxyglucose-positron emission tomography with computed tomography-based tool for the evaluation of joint counts and disease activity in patients with rheumatoid arthritis. Arthritis Rheumatol. 2019;71:1232-1240.Disclosure of Interests: :None declared

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

Abstract 17414: Increased Activity of Brain Region Governing Stress Perception is Associated With Plaque Vulnerability and Vascular Inflammation in Acute Myocardial Infarction Population; Retrospective and Prospective Study Evaluated by 18 FDG-PET/CT and OCT

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Eun Jin Park ◽  
Jae Seon Eo ◽  
Won-Young Jang ◽  
Dong Oh Kang ◽  
Cheol Ung Choi ◽  
...  
Keyword(s):  
High Risk ◽  
Prospective Study ◽  
Fdg Pet ◽  
Vascular Inflammation ◽  
Syntax Score ◽  
Plaque Vulnerability ◽  
Coronary Syndrome ◽  
Pet Ct ◽  
Amygdala Activity ◽  
Fdg Pet Ct

Backgrounds: Chronic mental stress is a major risk factor of coronary artery disease, but there is a lack of direct mechanistic evidence between brain amygdala activity, a neural stress center, versus plaque vulnerability in acute coronary syndrome. In this study, we aimed to evaluate whether brain amygdala activity in AMI patients assessed by 18 F-FDG PET/CT could be associated with vascular inflammation in carotid beds and high-risk coronary plaque features evaluated by OCT. Methods and Results: In retrospective analysis, the patients who underwent 18 F-FDG PET/CT and CAG at Korea University Guro Hospital (Seoul, Korea). Among 1802 patients underwent 18 F-FDG PET/CT from October 1 2009 to 31 December 31 2015, 230 patients received CAG. After excluding 36 patients who had active cancer or brain disease, 198 were stratified according to degree of coronary severity by syntax score [none (n=159); mild to moderate (n=26); severe (n=13)]. Brain amygdalar activity on PET was quantified as target-to-background ratio (TBR) of standardized uptake value (amygdalar SUV max /temporal SUV mean ). The amygdalar TBR was significantly higher in patients with severe coronary disease rather than those without coronary stenosis or mild to moderate stenosis assessed by syntax score (P=0.03). Intriguingly, among 13 patients with severe CAD, the amygdalar TBR significantly increased in the 6 patients presented as AMI compared to non-MI patients (P=0.03). In following prospective study, we performed 18 F-FDG PET/CT in AMI patients underwent percutaneous coronary intervention within index admission period, and in patients with chronic stable angina (CSA) as control. The plaque morphology in non-culprit segment of infarct-related artery (IRA) was estimated by OCT in AMI patients. Brain amygdalar TBR was significantly higher in AMI patients compared to CSA patients (p<0.05). In AMI patients, amygdalar activity was significantly associated with vascular inflammation quantified as carotid TBR (p<0.05). The increased amygdalar activity was associated with high-risk plaque characteristics of non-culprit segments of IRA. Conclusions: The amygdalar activity assessed by 18 F-FDG PET/CT was significantly higher in patients with AMI than CSA. This amygdalar activity was related to vulnerable plaque characteristics of IRA. Our results suggest that brain emotional activity in ACS could contribute to plaque instability in pan-vascular beds.

Abstract 11890: S100A8/A9 is Increased in Psoriasis Serum, Relates to Vascular Diseases and Activates Human Endothelial Cells

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Heather Teague ◽  
Qimin Ng ◽  
Monica Purmalek ◽  
Balaji Natarajan ◽  
Taufiq Salahuddin ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Fdg Pet ◽  
Vascular Inflammation ◽  
Vascular Diseases ◽  
Aortic Endothelial Cells ◽  
Pet Ct ◽  
Calcified Plaque ◽  
Fdg Pet Ct ◽  
Psoriasis Severity

Introduction: Psoriasis is a chronic inflammatory disorder of the skin affecting 2-4% of the population and is associated with an increased risk of cardiovascular events, specifically myocardial infarction. Methods: In a large, ongoing prospective cohort study of psoriasis and cardiovascular diseases (NCT01778569), we studied a consecutive sample (n=100) and aimed to investigate the potential role that S100A8/A9 may have in linking psoriasis to CV disease measured by FDG PET CT and coronary CTA. Furthermore, we conducted in vitro experiments on human aortic endothelial cells (ECs) to examine whether treatement with S100A9 activates these cells. We hypothesized that S100A8/A9 would relate to psoriasis severity, relate to in vivo vascular inflammation by FDG PET CT, non-calcified burden of coronary disease by CCTA and increase endothelial cell activation. Results: We observed that the S100A8/A9 heterodimer was elevated in serum (mean psoriasis: 2019 ± 100.1; non-psoriasis: 1634 ± 160.7; p = 0.02), correlating both with psoriasis severity score (adjusted β = 0.53, p = 0.02) and overall aortic vascular inflammation measured by FDG PET CT (adjusted β = 0.48, p = 0.02) beyond the Framingham Risk Score. Additionally, we found that S100A8/A9 was associated with direct coronary atherosclerosis measured by coronary CTA demonstrating an increase in total (β = 0.16, p = 0.04) and non-calcified plaque burden (β = 0.23, p = 0.003) but not dense calcified burden. When EC's were treated with S100A9, ICAM1, E-Selectin and VCAM1 gene expression levels increased 10-fold (p = 0.001), 86-fold (P = 0.007) and 20-fold (p = 0.0002) respectively compared to the untreated human aortic endothelial cells. Conclusions: S100A8/A9 related to psoriasis severity, in vivo vascular inflammation, non-calcified plaque in the coronary arteries and EC activation. These findings suggest this protein may play a role in linking psoriasis to CVD and a role in early atherosclerotic plaque formation. Ongoing studies aim to elucidate the source of S100A8/A9 in the blood and to characterize the signaling pathway utilized by S100A8/A9 to understand whether this pathway is broadly applicable to vascular diseases associated with chronic inflammation.

scholarly journals A COMPARISON OF VASCULAR INFLAMMATION IN RHEUMATOID ARTHRITIS, PSORIASIS AND HEALTHY CONTROLS BY FDG-PET/CT: A PILOT STUDY

2013 ◽  
Vol 61 (10) ◽  
pp. E1056
Author(s):  
Nehal N. Mehta ◽  
Nikhil H. Sheth ◽  
Joshua Baker ◽  
Alexis Ogdie ◽  
Anna Raper ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Pilot Study ◽  
Fdg Pet ◽  
Vascular Inflammation ◽  
Healthy Controls ◽  
Pet Ct ◽  
Fdg Pet Ct

INTERLEUKIN-1 BETA IS ASSOCIATED WITH AORTIC VASCULAR INFLAMMATION ASSESSED BY 18-FDG PET/CT IN PATIENTS WITH PSORIASIS

2018 ◽  
Vol 71 (11) ◽  
pp. A1481
Author(s):  
Agastya Belur ◽  
Youssef Elnabawi ◽  
Amit Dey ◽  
Aparna Sajja ◽  
Aditya Goyal ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Vascular Inflammation ◽  
Interleukin 1 ◽  
Interleukin 1 Beta ◽  
Pet Ct ◽  
Fdg Pet Ct

Hypercholesterolemia In Imatinib Intolerant/Resistant CML-CP Patients Treated With Nilotinib: A Retrospective Analysis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1503-1503 ◽  
Author(s):  
Devendra K. Hiwase ◽  
David T Yeung ◽  
Lisa Carne ◽  
David Ross ◽  
Andrew Grigg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lipid Profile ◽  
Retrospective Analysis ◽  
Board Of Directors ◽  
Research Funding ◽  
Lipid Profiles ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Advisory Committees ◽  
Before And After

Abstract Background CML patients (pts) enjoy prolonged leukaemia-free survival with tyrosine kinase inhibitor (TKI) treatment. Addressing common non-CML causes of morbidity and mortality such as cardiovascular disease (CVD) and its associated risk factors is therefore increasingly important. Anecdotal evidence suggests a possible association between nilotinib (NIL) therapy and vascular events though there is little good quality evidence in this regard. The incidence of hyperlipidaemia and hyperglycaemia is higher in NIL-treated pts compared to imatinib- (IM) treated pts; conversely IM treatment may retard development of dyslipidaemia and hyperglycaemia. This retrospective analysis assessed the lipid profile of CML-CP pts before and after changing from IM to NIL therapy. Method Plasma lipid profile (total cholesterol, LDL, HDL and triglycerides), TKI exposure, and CVD risk factors before and after switchover to NIL of chronic phase CML pts were analysed. Baseline measurements were done during IM treatment or within 2 weeks of changing from IM to NIL. Follow-up results were obtained at least 1 month after starting NIL. Results Thirty-one CML pts were switched to NIL (median dose 400mg bd) after a median of 27 (1-96) months of IM therapy, predominantly for intolerance (16/31, 52%) or for failure to achieve deep molecular responses (13/31, 42%). Median age at NIL start was 51 (17-80) years (Table I). After switching to NIL, three pts had new onset PVD/IHD and one patient had multiple recurrences of PVD. Antihypertensive and hypoglycaemic medications were started in one additional patient each after switching over to NIL. Three pts were excluded from further analysis because of lack of data (n=2) or pre-existing dyslipidemia (n=1). The remaining pts had 90 TC assays, 72 of which were full lipid profiles whilst on NIL. Observations were censored at the time of statin commencement. Median time to 1st lipid measurement on NIL was 108 days (28-633) after switching. Median TC on IM was 4.7mM (2.1-6.4), compared to 6.1mM on NIL (3.1-8.5). Median peak TC on NIL was 6.8mM. Full fasting lipid profiles available for 11 pts before and after switching showed significantly increased LDL to be the major contributor to the increase in TC (Fig. 2). Thirteen pts had a fasting TC >5.5 mM (210 mg/dL) whilst on NIL, peaking at 312 days (medians). Eight of 13 pts started statins treatment for dyslipidemia whilst on NIL; (all retrospectively confirmed to be appropriate according to Australian National Heart Foundation guidelines, using a composite measure of CVD risk); whilst the other 5 were offered lifestyle modifications only. Of note, 2 pts had dyslipidaemia prior to starting IM treatment, discontinued statins whilst on IM, and had recurrence of dyslipidaemia after switching to NIL necessitating resumption of statin treatment. In addition, the 2 pts with PVD were also offered statins (total starting statin n=10) Discussion This retrospective analysis showed a high incidence of dyslipidemia in a cohort of CML pts treated with second-line NIL after IM therapy; 10/31 pts required lipid lowering agent. While the epidemiological association between nilotinib and CVD remains controversial, the increase in TC may have a contributing effect. Monitoring lipid levels in NIL-treated pts is prudent, along with screening for and minimisation of concomitant CVD risk factors, especially in pts previous treated with IM which may mask underlying metabolic syndromes. # DKH DTY and LC contributed equally to this work. Disclosures: Hiwase: Novartis Pharmaceuticals: Research Funding. Yeung:Novartis: Honoraria, Research Funding; BMS: Honoraria. Hughes:Novartis: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding, Speakers Bureau; BMS: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; Ariad: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding.

COMPARISON OF THE TWO METHODS FOR THE VASCULAR INFLAMMATION USING FDG PET/CT OF THE AORTA

2016 ◽  
Vol 32 (10) ◽  
pp. S152-S153
Author(s):  
V. Corrales-Medina ◽  
C. Habibi ◽  
R. deKemp ◽  
P. Macpherson ◽  
C. Kelly ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Vascular Inflammation ◽  
Pet Ct ◽  
Fdg Pet Ct
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