Two-year change in 18F-sodium fluoride uptake in major arteries of healthy subjects and angina pectoris patients.

Reza Piri,Poul Flemming Høilund-Carlsen,Pooriya Riyahimanesh,Gauher Lici,Oke Gerke,Abass Alavi

doi:10.1007/s10554-021-02263-7

Abstract

To examine 2-year changes in carotid and aortic 18F-sodium fluoride (NaF) uptake in both healthy controls and angina pectoris patients. Twenty-nine healthy subjects and 20 angina pectoris patients underwent 90-min NaF-PET/CT twice 2 years apart. The carotids and three sections of the aorta (arch, thoracic, abdominal) were manually segmented. NaF uptake was expressed as the mean and total standardized uptake values without and with partial volume correction (SUVmean, SUVtotal and pvcSUVmean, pvcSUVtotal). Insignificant tendencies were higher NaF uptake in angina patients at both time points with less uptake in healthy subjects and higher uptake in angina patients after 2years. Thus, aortic pvcSUVmean of angina patients was 1.14 ± 0.35 and 1.29 ± 0.71 at baseline and after 2years vs. 0.99 ± 0.31 and 0.95 ± 0.28 in healthy subjects. A similar pattern was observed for the carotid pvcSUVmean. NaF uptake at baseline could not predict a change in CT-calcification after 2years. NaF uptake in all parts of the aorta correlated positively with age. There was an insignificant, but consistent, tendency for slightly higher arterial NaF uptake in the angina group indicating more ongoing microcalcification at both time points in patients than healthy subjects. The 2-year changes were in both groups very small suggesting that the atherosclerotic process is slow, albeit with a tendency of slight decreases among healthy controls and slight increases in angina patients despite statin therapy in half of these.

Highlights

With increasing life expectancy and proportion of older individuals in the population, there is a growing concern about chronic morbidities such as cardiovascular diseases (CVD)
NaF uptake at baseline could not predict a change in computed tomography (CT)-calcification after 2 years
The 2-year changes were very small in both groups, albeit with a tendency of slight decreases among healthy controls and slight increases in angina patients despite statin therapy in half of these

Summary

Introduction

With increasing life expectancy and proportion of older individuals in the population, there is a growing concern about chronic morbidities such as cardiovascular diseases (CVD). Despite the significant decline in mortality from coronary heart disease and stroke during several decades, CVDs remain the number one cause of mortality worldwide [1]. The cause of decline is probably multifactorial, fueled by progress in both prevention and treatment, including widespread use of statins to lower circulating cholesterol levels and timely use of thrombolysis and stents in acute coronary syndrome. There remain many questions about this decline. There is evidence that the rate of decline may have abated and may even be showing early signs of reversal in some population groups [2]. CVDs are one of the most challenging fields for health care systems, in particular, because symptoms of CVDs tend to appear late in the course of the disease, meaning that treatments must be directed at alleviating symptoms or complications rather than prevention

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