Author + information
- Received July 19, 2017
- Revision received October 22, 2017
- Accepted November 11, 2017
- Published online January 22, 2018.
- Kazuma Ohyama, MDa,
- Yasuharu Matsumoto, MD, PhDa,
- Kentaro Takanami, MD, PhDb,
- Hideki Ota, MD, PhDb,
- Kensuke Nishimiya, MD, PhDa,
- Jun Sugisawa, MDa,
- Satoshi Tsuchiya, MDa,
- Hirokazu Amamizu, MDa,
- Hironori Uzuka, MD, PhDa,
- Akira Suda, MDa,
- Tomohiko Shindo, MD, PhDa,
- Yoku Kikuchi, MD, PhDa,
- Kiyotaka Hao, MD, PhDa,
- Ryuji Tsuburaya, MD, PhDa,
- Jun Takahashi, MD, PhDa,
- Satoshi Miyata, PhDa,
- Yasuhiko Sakata, MD, PhDa,
- Kei Takase, MD, PhDb and
- Hiroaki Shimokawa, MD, PhDa,∗ ()
- aDepartment of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- bDepartment of Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
- ↵∗Address for correspondence:
Dr. Hiroaki Shimokawa, Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Background Recent studies suggested that perivascular components, such as perivascular adipose tissue (PVAT) and adventitial vasa vasorum (VV), play an important role as a source of various inflammatory mediators in cardiovascular disease.
Objectives The authors tested their hypothesis that coronary artery spasm is associated with perivascular inflammation in patients with vasospastic angina (VSA) using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT).
Methods This study prospectively examined 27 consecutive VSA patients with acetylcholine-induced diffuse spasm in the left anterior descending artery (LAD) and 13 subjects with suspected angina but without organic coronary lesions or coronary spasm. Using CT coronary angiography and electrocardiogram-gated 18F-FDG PET/CT, coronary PVAT volume and coronary perivascular FDG uptake in the LAD were examined. In addition, adventitial VV formation in the LAD was examined with optical coherence tomography, and Rho-kinase activity was measured in circulating leukocytes.
Results Patient characteristics were comparable between the 2 groups. CT coronary angiography and ECG-gated 18F-FDG PET/CT showed that coronary PVAT volume and coronary perivascular FDG uptake significantly increased in the VSA group compared with the non-VSA group. Furthermore, optical coherence tomography showed that adventitial VV formation significantly increased in the VSA group compared with the non-VSA group, as did Rho-kinase activity. Importantly, during the follow-up period with medical treatment, both coronary perivascular FDG uptake and Rho-kinase activity significantly decreased in the VSA group.
Conclusions These results provide the first evidence that coronary spasm is associated with inflammation of coronary adventitia and PVAT, where 18F-FDG PET/CT could be useful for disease activity assessment. (Morphological and Functional Change of Coronary Perivascular Adipose Tissue in Vasospastic Angina [ADIPO-VSA Trial]; UMIN000016675)
This work was supported in part by grants-in-aid for scientific research (18890018, 16K19384) and the Global COE Project (F02) and grants-in-aid (H22-Shinkin-004) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology, Tokyo, Japan; and a grant for young investigators of translational research from Tohoku University Hospital. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 19, 2017.
- Revision received October 22, 2017.
- Accepted November 11, 2017.
- 2018 American College of Cardiology Foundation