Tracking Early Atherosclerosis by Audiometry; A Review of Studies in a High Risk Population

Abstract

Objectives: Increasing levels of atherosclerosis correlate with increasing degrees of hearing loss. We hypothesized that arterial inflammation observed on FDG-PET/CT scans correlates with audiogram test results and that Major Adverse Cardiovascular Events occur in subjects with severe hearing loss (>40 dB). Methods: A FDG-PET/CT imaging prospective study was performed in an NIH trial including 115 rheumatoid arthritis subjects over age 50 without a history of cardiovascular disease, and 22 subjects were selected for concurrent audiograms. All were evaluated by 18-fluorodeoxyglucose positron emission tomography computed tomography scans and audiogram tests, at baseline and 6 months. In our institution, 320 similar RA subjects were identified over age 50 with no prior cardiovascular disease and chart review completed for 10 years to evaluate MACE occurrence. Audiograms were available for the 320 retrospective patients. Results: In the imaging study, at baseline there was a strong correlation between arterial inflammation on FDG-PET/CT and hearing test results (p<0.002). Hearing loss over 30 decibels was strongly associated with high levels of inflammation on FDG-PET/CT imaging. In the larger 320 retrospective group, there were 11 MACE (3.4%) in the 10 years period which occurred in subjects with even greater hearing loss (average measurement was over 50 dB). Conclusion: Atherosclerosis was identified through FDG-PET/CT imaging studies and hearing tests. All MACE occurred in patients with significant hearing loss. Testing comprised a unique population with systemic inflammation from RA. If confirmed in larger studies in the general population, audiograms might provide a cost- effective substitute for FDG-PET/CT imaging and provide potentially an improved individual patient cardiovascular risk assessment. Audiograms may infer cardiovascular