Abstract MP24: Correlation Between Blood Pressure And Inflammation In The Thoracic Aorta Of HIV Patients With And Without Cocaine Use As Assessed By FDG-PET/CT

Objectives: Cocaine exerts various adverse effects on the cardiovascular system, something that can be further exasperated in HIV positive individuals. In this study, we aimed to assess the atherosclerotic activity in the thoracic aorta of HIV patients with and without cocaine use, hypothesizing that there is a stronger association between blood pressure and inflammation in individuals with cocaine use as quantified by FDG-PET/CT. Methods: Patients with HIV on antiretroviral therapy (viral load <200 copy/ml) were enrolled with written consent by the University of Pennsylvania. Patients were injected with 15 mCi of 18F-FDG and full-body PET scans were acquired 120 minutes post-injection; low dose CT was used for anatomical localization of PET images. Artifact in either PET or CT images led to exclusion from analysis. OsirixMD (v9.0.02) was used to place regions of interest on axial slices surrounding ascending aorta, aortic arch, and descending aorta. Total average standard uptake mean (aSUVmean) was calculated for the aorta of each patient. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded pre-imaging; mean arterial pressure (MAP) was calculated. Linear regressions were employed for statistical analysis. Results: There was a positive correlation between SBP, DBP, and MAP and uptake in HIV patients with cocaine use (N=11; SBP: r=0.66, p=0.0270; DBP: r=0.65, p=0.0299; MAP: r=0.68, p=0.0207). No correlations were seen in HIV patients without cocaine use (N=18; SBP: r=0.33, p=0.1850; DBP: r=0.19, p=0.4593; MAP: r=0.29, p=0.2502). Conclusions: In our study, blood pressure correlated positively with increased FDG uptake in patients with cocaine use. This highlights the added effect of cocaine use on aortic inflammation in HIV individuals.

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Abstract P043: Correlation Between Blood Pressure And Left Ventricular Metabolism In HIV Individuals With And Without Cocaine Use As Assessed By FDG-PET/CT

Hypertension ◽

10.1161/hyp.76.suppl_1.p043 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

Abhijit Bhattaru ◽

Rina Ghorpade ◽

Chaitanya Rojulpote ◽

Paco E Bravo ◽

Shivaraj Patil ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Activity ◽

Fdg Pet ◽

Structural Changes ◽

Left Ventricular ◽

Myocardial Uptake ◽

Hiv Patients ◽

Cocaine Use ◽

Pet Ct ◽

Fdg Pet Ct

Objectives: Elevated blood pressure from cocaine can increase left ventricular (LV) metabolic activity, leading to structural changes such as hypertrophy. We aimed to assess the association between blood pressure and LV myocardial uptake of FDG, hypothesizing that HIV individuals with raised blood pressure will have higher FDG uptake. Methods: University of Pennsylvania enrolled patients with HIV on antiretroviral therapy with viral load <200 copy/ml. Cocaine usage in moderate to high amounts (cocaine disease score≥5) was subsequently documented. Full body PET scans were acquired 120 minutes post-injection of 18F-FDG(15 mCi) with low-dose CT scans for attenuation correction. Patients with imaging artifacts were excluded from the analysis. Regions of interest were drawn on axial slices using computer software (OsirixMD, v9.0.02) around LV myocardium. Average standard uptake value means (aSUVmean) were calculated for each patient. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were obtained prior to imaging; mean arterial pressure (MAP) was subsequently calculated. Linear regressions and Mann-Whitney U tests were employed for statistical analysis. Results: aSUVmean was higher in HIV patients with cocaine use (U(Ncocaine = 11, Nno cocaine=11) = 93, p=0.0336). In patients with cocaine use, there was a positive correlation between blood pressure and aSUVmean (SBP: r=0.70, p=0.0164; DBP: r=0.69, p=0.0185; MAP: r=0.72, p=0.0120). No significant correlations were found in HIV patients without cocaine use (SBP: r=0.03, p=0.9239; DBP: r=-0.50, p=0.1153; MAP: r=-0.32, p=0.3345). Conclusions: LV myocardial metabolism was more strongly positively correlated with blood pressure in HIV patients using cocaine compared to HIV patients without cocaine. These data suggest FDG-PET/CT can be used to monitor LV metabolic activity and allow for timely assessment of structural changes caused by cocaine use and hypertension.

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Abstract 13835: Anti-inflammatory Effect of Rosuvastatin in Patients With HIV Infection: A Randomized Controlled FDG-PET Study

Circulation ◽

10.1161/circ.142.suppl_3.13835 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Kevin E Boczar ◽

Elliott Faller ◽

Jerry Wang ◽

Wanzhen Zeng ◽

Gary R Small ◽

...

Keyword(s):

Bone Marrow ◽

Thoracic Aorta ◽

Fdg Pet ◽

Control Group ◽

Hiv Patients ◽

Framingham Risk ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Inflammatory Effect

Introduction: Cardiovascular disease (CVD) is a major source of morbidity and mortality in HIV+ patients, which is thought to be in part due to a state of persistent systemic inflammation that results in accelerated atherosclerosis. Hypothesis: We hypothesized that inflammation, as measured by 18F-fluorodeoxyglucose (18F-FDG) uptake measured by 18F-FDG positron emission tomography/computed tomography (18F-FDG-PET/CT) in the bone marrow, spleen and thoracic aorta would improve in HIV+ patients following therapy with rosuvastatin compared to HIV+ patients not receiving a statin. Methods: HIV+ patients with a moderate Framingham risk score were enrolled in the study and randomized to treatment with rosuvastatin or usual treatment for 6 months. Patients were matched for age, sex, smoking status, Framingham risk score, duration of anti-retroviral therapy (ART) and type of ART. Fasting blood was collected and 18F-FDG-PET/CT imaging of bone marrow, spleen, and thoracic aorta was performed at baseline and 6 months. Results: Thirty-five HIV+ patients were enrolled in the study; 17 were randomized to treatment with rosuvastatin and 18 were randomized to the control group. There was a significant drop in the 18F-FDG bone marrow, spleen and thoracic aortic uptake in the statin-treated group compared to the control group (bone marrow: -10.3±16.9% versus 5.0±18.9%, p=0.0262; spleen: -9.8±20.3% versus 11.3±28.8%, p=0.0497; thoracic aorta: -8.6±24.5% versus 12.6±29.5%, p=0.0343). 18F-FDG changes over the study period are shown in Figure 1. Conclusions: The present study observed a significant decrease in 18F-FDG-PET uptake in the bone marrow, spleen, and thoracic aorta following treatment with rosuvastatin for 6 months in HIV+ patients. These data suggest a wide-range anti-inflammatory effect of rosuvastatin in HIV+ individuals with well-controlled infection on ART, ultimately resulting in decreased inflammatory activity in the arterial walls of these patients.

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Blood pool activity on F-18 FDG PET/CT as a possible imaging biomarker of metabolic syndrome

Scientific Reports ◽

10.1038/s41598-020-74443-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Ji-In Bang ◽

Chang Mo Moon ◽

Hye Ok Kim ◽

Seo Young Kang ◽

Hai-Jeon Yoon ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Logistic Regression ◽

Adipose Tissue ◽

Fdg Pet ◽

Binary Logistic Regression ◽

Hdl Cholesterol ◽

Blood Pool ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Association of blood pool (BP) and adipose tissue activity from F-18 fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) with the parameters of metabolic syndrome (MetS) and different MetS/obesity types were investigated. 245 subjects underwent FDG PET/CT scan for health check-ups were investigated retrospectively. Associations of BP (BP SUV: SUVmax, SUVmean), visceral (VAT SUV), and subcutaneous adipose tissue (SAT SUV) activity with parameters of MetS, body mass index (BMI), and lipid profiles were analyzed. MetS/obesity types were subdivided into metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). BP SUV was higher in subjects with MetS (t-test, P < 0.005), and was associated with MetS from multivariable binary logistic regression (OR 5.232 P = 0.010). BP SUV was statistically higher in MUO than in MHO (P < 0.05) along with blood pressure, triglycerides, and HDL-cholesterol. Multivariable binary logistic regression analysis showed MUO had higher blood pressure and BP SUV, while lower HDL-cholesterol relative to MHO after adjusting for triglycerides.

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Role and interpretation of FDG-PET/CT in HIV patients with fever of unknown origin: a prospective study

Journal of the International AIDS Society ◽

10.7448/ias.15.6.18107 ◽

2012 ◽

Vol 15 (6(Suppl 4)) ◽

Author(s):

C Martin ◽

C Castaigne ◽

M Tondeur ◽

P Flamen ◽

S De Wit

Keyword(s):

Prospective Study ◽

Fdg Pet ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Hiv Patients ◽

Pet Ct ◽

A Prospective Study ◽

Fdg Pet Ct

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Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis

Scientific Reports ◽

10.1038/s41598-021-85857-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amir Emamifar ◽

Torkell Ellingsen ◽

Anne Pernille Hermann ◽

Søren Hess ◽

Oke Gerke ◽

...

Keyword(s):

Blood Pressure ◽

Body Composition ◽

Arterial Stiffness ◽

Giant Cell Arteritis ◽

Polymyalgia Rheumatica ◽

Fdg Pet ◽

Glucocorticoid Treatment ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

AbstractIdentifying comorbidities in polymyalgia rheumatica/giant cell arteritis (PMR/GCA) is crucial for patients’ outcomes. The present study aimed to evaluate the impact of the inflammatory process and glucocorticoid treatment on aortic arterial stiffness and body composition in PMR/GCA. 77 patients with newly diagnosed PMR/GCA were treated with oral glucocorticoids and followed for 40 weeks. Aortic pulse wave velocity (PWV) was measured at baseline and during the follow-up period and compared to the results of temporal artery biopsy (TAB) and 18F-FDG PET/CT. Body composition was assessed by total body DXA at baseline and the end of the study. Of 77 patients (49 (63.6%) female, mean of age: (71.8 ± 8.0)), 64 (83.1%) had pure PMR, 10 (13.0%) concomitant PMR and GCA, and 3 (3.9%) pure GCA. Compared to baseline values, aortic PWV was initially decreased at week 16 (p = 0.010) and remained lower than baseline at week 28 (p = 0.002) and week 40 (p < 0.001), with no association with results of TAB and 18F-FDG PET/CT. Aortic PWV was significantly associated with age, male gender, left systolic and diastolic blood pressure, right diastolic blood pressure, and CRP. Total bone mineral content (BMC) was decreased in both genders (p < 0.001), while fat mass (FM) was significantly increased (p < 0.001). However, lean body mass did not significantly change during the study. Changes in FM were correlated with cumulative prednisolone dose (rho: 0.26, p = 0.031). Glucocorticoid treatment of patients with PMR/GCA had several prognostic impacts. Arterial stiffness was decreased due either to the treatment or a reduction in the inflammatory load. Additionally, treatment led to changes in body composition, including a decrease in BMC and FM excess.

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