Association of glucose uptake of visceral fat and acute myocardial infarction: a pilot 18 F-FDG PET/CT study
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Cardiovascular Diabetology Open Access
ORIGINAL INVESTIGATION
Association of glucose uptake of visceral fat and acute myocardial infarction: a pilot 18F‑FDG PET/CT study Kisoo Pahk1, Eung Ju Kim2, Chanmin Joung3, Hong Seog Seo2* and Sungeun Kim1*
Abstract Background: Inflamed visceral adipose tissue (VAT) facilitates chronic inflammation in atherosclerotic lesions thereby leading to increased risk of coronary artery disease (CAD). In this study, we evaluated the glucose uptake of VAT and the carotid artery with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) and their association with CAD, including acute myocardial infarction (AMI). Methods: A total of 90 participants were enrolled (32 with AMI, 33 with chronic stable angina; CSA, and 25 control participants) and undertook 18F-FDG PET/CT. VAT glucose uptake was measured by using maximum standardized uptake value (SUVmax) of VAT region. The target-to-background ratio (TBR) of carotid artery was defined as the SUVmax of carotid artery divided by the SUVmax of jugular vein. The SUVmax of spleen, bone-marrow (BM), and highsensitivity C-reactive protein (hsCRP) were used for the assessment of systemic inflammatory activity. Results: VAT SUVmax was highest in participants with AMI, intermediate in participants with CSA, and lowest in control participants. Carotid artery TBR and systemic inflammatory surrogate markers including spleen SUVmax, BM SUVmax, and hsCRP were also higher in the AMI group than in the CSA or control group. Furthermore, VAT SUVmax showed significant positive correlation with carotid artery TBR, spleen SUVmax, BM SUVmax, and hsCRP. In multivariate linear regression and logistic regression analyses, VAT SUVmax was independently associated with carotid artery TBR and AMI. Conclusions: Glucose uptake of VAT assessed by 18F-FDG PET/CT was associated with the severity of CAD and synchronized with the carotid artery inflammation in participants with CAD. Keywords: Coronary artery disease, Visceral fat, Inflammation, Atherosclerosis, Positron-emission tomography Background Cardiovascular diseases (CVD) are the leading cause of mortality in worldwide and approximately 40% of these deaths are attributed to coronary artery disease (CAD) [1, 2]. One of the main underlying pathological processes leading to CAD is atherosclerosis which can further *Correspondence: [email protected]; [email protected] 1 Department of Nuclear Medicine, Korea University Anam Hospital, 73, Inchon‑ro, Seongbuk‑gu, Seoul 02841, Republic of Korea 2 Department of Cardiovascular Center, Korea University Guro Hospital, 148, Gurodong‑ro, Guro‑gu, Seoul 08308, Republic of Korea Full list of author information is available at the end of the article
develop into plaque erosion or rupture that eventually manifest as angina and/or acute myocardial infarction (AMI) [3]. Furthermore, accumulating evidences suggest that dysfunctional visceral adipose tissue (VAT) is the key player underlying the risk of CAD development through the promotion of chronic inflammation i
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