Author + information
- Marc Dweck,
- Juet H. Khaw,
- Greg KZ Sng,
- Elton Luo,
- Andrew Baird,
- Michelle C. Williams,
- Phoebe E. Makiello,
- Nikhil V. Joshi,
- James HF Rudd and
- David E. Newby
The pathophysiology of aortic stenosis is similar to atherosclerosis and skeletal bone formation. Using non-invasive imaging we compared calcification and inflammation activity in the aortic valve with that measured in atherosclerosis and bone.
Positron emission and computed tomography was performed using 18F-sodium fluoride (18FNaF; calcification) and 18Ffluorodeoxyglucose (18FFDG; inflammation) in 101 patients with calcific aortic valve disease (81 aortic stenosis, 20 sclerosis). Calcium scores and PET tracer activity (tissue to background ratio; TBR) were measured in the aortic valve, coronary arteries, thoracic aorta and bone.
Over 90% of the cohort had co-existent calcific atheroma, yet correlations between calcium scores were weak or absent (valve vs aorta r2=0.09, P0.05 for all). 18FNaF activity in the valve was 28% higher than in the aorta (2.7±0.8 vs 2.1±0.3 P<0.01) and correlated only weakly with 18FNaF uptake in other regions (valve vs. aorta r2=0.17, P<0.01; valve vs. coronary arteries r2=0.17, P<0.01; valve vs. bone r2=0.00, P=0.81). In contrast 18FFDG activity was lower in the valve than aortic atheroma (1.6±0.2 vs.1.8±0.2, P<0.01) with a good association between uptake in these regions (r2=0.33, P<0.01).
In patients with aortic stenosis, disease activity appears to be dominated by local calcific processes that are distinct from activity in atheroma and skeletal bone.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Novel Applications of SPECT and PET
Abstract Category: 21. Imaging: Nuclear
Presentation Number: 1271-360
- 2013 American College of Cardiology Foundation