Prognostic value of 18F-fluorodeoxyglucose PET-CT imaging in acute aortic syndromes: comparison with serological biomarkers of inflammation

被引:14
作者
Gorla, Riccardo [1 ,7 ]
Erbel, Raimund [1 ,8 ]
Kuehl, Hilmar [2 ]
Kahlert, Philipp [1 ]
Tsagakis, Konstantinos [3 ]
Jakob, Heinz [3 ]
Mahabadi, Amir-Abbas [1 ]
Schlosser, Thomas [4 ]
Bockisch, Andreas [2 ]
Eggebrecht, Holger [5 ]
Bossone, Eduardo [6 ]
Janosi, Rolf Alexander [1 ]
机构
[1] Univ Duisburg Essen, West German Heart & Vasc Ctr Essen, Dept Cardiol, Essen, Germany
[2] Univ Duisburg Essen, Univ Hosp Essen, Dept Nucl Med, Essen, Germany
[3] Univ Duisburg Essen, West German Heart & Vasc Ctr Essen, Dept Thorac & Cardiovasc Surg, Essen, Germany
[4] Univ Duisburg Essen, Univ Hosp Essen, Dept Radiol, Essen, Germany
[5] Cardioangiol Ctr Bethanien, Frankfurt, Germany
[6] Univ Hosp, Heart Dept, Salerno, Italy
[7] Univ Insubria, Osped Circolo Varese, Cardiol Clin, Varese, Italy
[8] Univ Clin Cardiol, West German Heart & Vasc Ctr Essen, D-45147 Essen, Germany
关键词
PET-CT; Acute aortic syndromes; D-dimer; C-reactive protein; D-DIMER; WALL INFLAMMATION; VESSEL WALL; TOMOGRAPHY; DISSECTION; MORTALITY; ANEURYSMS; REPAIR;
D O I
10.1007/s10554-015-0725-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim of this study was to investigate the relationship between F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) findings and serological biomarkers of inflammation and the related discriminant value of unfavourable outcome during follow-up in patients with acute aortic syndromes (AAS). Sixty patients with AAS underwent PET-CT imaging during the hospitalization along with measurement of C-reactive protein (CRP) and D-dimer (D-d) serum levels. An aortic wall pathology was considered PET-positive by a maximum standardized uptake value (SUVmax) > 2.5. A combined endpoint of major adverse events (MAE) including aorta-related mortality, disease progression and re-intervention was used to compare patient subgroups at 3-year follow-up. PET-CT detected an elevated FDG uptake within the aortic wall in 25 (41.7 %) patients. PET-positive patients showed significantly increased CRP levels (10.0 +/- A 6.6 mg/dL) and tended to higher D-d levels (5.1 +/- A 3.9 mg/L), compared to PET-negative patients (5.8 +/- A 6.1 mg/dL and 3.1 +/- A 4.7 mg/L respectively; P = 0.048, P = 0.19). At 3-year follow-up, all-cause mortality and MAE were higher in the PET-positive (21.7 and 47.8 % respectively) than PET-negative group (0.0 and 13.3 % respectively; P = 0.012, P = 0.006). On Kaplan-Meier analysis, PET-positive patients were at higher risk of MAE (P = 0.031). This tendency was more evident by combining PET results with D-d levels at a cutoff value of 4.8 mg/L (P < 0.001). In patients with AAS, a pathological glucose uptake in aortic wall lesions by PET-CT was associated with high CRP levels and increased mortality and MAE at 3-year follow-up. The combination of PET results with D-d levels had the best discriminant value of MAE.
引用
收藏
页码:1677 / 1685
页数:9
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