Abstract 14360: Clinical Significance of the Assessment of Valvular Calcification Using 18 F-sodium Fluoride Positron Emission Tomography

Abstract

Introduction: With an aging population, valvular heart disease (VHD) of a degenerative etiology has been increasing. Although calcification of valves and mitral annulus (MAC) increase in the elderly, these calcification lesions are considered as one of the causes of embolic stroke of undetermined source (ESUS). On the other hand, it is difficult to evaluate the instability of calcification using echocardiology or CT and to clarify the relationship between the instability of calcification and the onset of cerebral infarction. 18 F-Sodium Fluoride ( 18 F-NaF) is a Positron Emission Tomography (PET) tracer acts as a marker of newly developing calcium in the cardiovascular system. Therefore, we evaluated the qualitative evaluation of calcification lesions using NAF and the onset of cerebral infarction. Methods/Results: One hundred and twenty-five preoperative orthopedic patients (78.0±6.3 years old, 13 male) underwent 18 F-NaF-PET/CT and echocardiography between February 2015 and March 2019 and the accumulation was analyzed in each calcification. MAC was admitted in 46 patients, Aortic valve calcification was in 22 patients, and Mitral valve calcification was in 48 patients. The accumulation of 18 F-NaF on calcified lesions was admitted in 41, 33, 48 patients, each. History or new onset of cerebral infarction was in 14 patients, and among them 13 patients (92.9%) had the accumulation of 18 F-NaF on calcified lesions. Calcification with the accumulation of 18 F-NaF was correlated with cerebral infarction (p<0.01 by chi-square) and the uptake grade of 18 F-NaF on calcification was linearly correlated with the onset of cerebral infarction. Conclusions: The accumulation of 18 F-NaF may predict the instability of calcification and the risk of cerebral infarction.